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Local hormone therapy - clinical indications, benefits and potential risks

Urogenital atrophy is observed in 10 % to 40 % of all postmenopausal women with predominant symptoms of introital dryness, dyspareunia with introital burning or recurrent urinary tract infections. Young women using hormonal contraception may also suffer from vulvovaginal atrophy, especially after severe vaginitis. Local application of estrogen creams or vaginal tablets is generally accepted as the most effective treatment of vulvovaginal atrophy. Intravaginal application of 0.5 mg estriol daily for two to three weeks followed by twice weekly administration has been proven to be of value in maintenance therapy. Estriol is not metabolized to estradiol or estron. For women with a history of hormone receptor positive breast cancer suffering from vulvovaginal atrophy, vaginal estriol in the commonly applied dosage of 0.5 mg twice weekly or even a much lower daily dose of 0.03 mg might be the therapy of choice. However, larger studies are necessary to assess the risk of breast cancer recurrence.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2012; 8(1): 4-14

Estriol, estradiol, urogenital atrophy, dyspareunia, postmenopause

Andreas Clad
Universitäts-Frauenklinik Freiburg, Hochschulambulanz
und Sektion Gynäkologische Infektiologie, Freiburg
Reviewer: Alfred O. Mueck, Tübingen
und Petra Stute, Bern, Schweiz

Clad A. Lokale ... Gynakol Geburtsmed Gynakol Endokrinol 2012; 8(1): 4-14 publiziert 31.03.12 ©akademos Wissenschaftsverlag 2012 ISSN 1614-8533