Early Data Show Low-Dose Estrogen Cream Improves Urogenital Atrophy.

HOT SPRINGS, VA. -- A very low dose of locally applied estrogen effectively treats the urethral symptoms of uro-genital atrophy without creating unacceptable spikes in systemically absorbed estrogen levels, according to preliminary findings from a small study.

In research that was aimed at identifying safe treatment options for women with a history of estrogen-mediated cancers, Dr. JoAnn V. Pinker ton and her colleagues at the University of Virginia, Charlottesville, analyzed systemic estrogen absorption rates among seven symptomatic postmenopausal women who did not have a history of either breast or uterine cancer.

The women received 10[micro]g of estrogen (Estrace), a potency one-tenth the normally prescribed dose. Patients used the cream daily for 3 weeks and then twice weekly for 49 weeks, Dr. Pinkerton said at the annual meeting of the South Atlantic Association of Obstetricians and Gynecologists.

At 3 months, 82% of the 22 vaginal and urinary symptoms reported at baseline (about three, symptoms per patient) were improved or cured and 18% were unchanged.

The improvement was statistically significant for urethral symptoms, vaginal pH, and vaginal and urethral cytology; the vaginal cytology improved to premenopausal levels, similar to improvements that were seen with standard-dose estrogen.

Vaginal symptoms, such as dyspareunia, improved in three of seven patients, which was not considered statistically significant.

"It is possible that a higher dose of vaginal estrogen may be needed to adequately treat the vaginal symptoms," Dr. Pinkerton noted during the meeting, which was also sponsored by the American College of Obstetricians and Gynecologists.