Estriol serum levels in new and chronic users of vaginal estriol cream: A prospective observational study

Abstract

Aims: To quantify estriol serum concentrations in "new" and "chronic users" of topical estriol cream using quantitative liquid chromatography tandem mass spectrometry. Methods: In this singlecentre prospective observational study, postmenopausal women with urogynaecological complaints were enrolled: 40 had not used topical estriol previously ("new users") and 50 had been applying estriol cream for more than 12 weeks ("chronic users"). In "new users," serum estriol levels were measured at baseline and after 12 weeks use. Estriol cream 1 mg/g was used daily for 3 weeks, then twice weekly with applicator (group 1A) or digitally (group 1B) or three times per week digitally (group 1C). "Chronic users" applied the cream twice (n = 7) or three (n = 43) times perweek. Serum samples were taken in the morning after using cream the previous night. The main outcome measures were estriol serum concentrations in "new" and "chronic users" of estriol cream.Results: Baseline serum estriol concentrations were less than 5 pmol/L in all 40 "new users." At 12 weeks, the 12-hour serum estriol levels ranged from less than 5 to 494 pmol/L (median 22.8; Interquartile range [IQR] 9.2-108.5). Seven "new users" had levels more than 100 pmol/L. Most of the 50 "chronic users" also had 12-hour levels less than 100 pmol/L (median 15.1 pmol/L [IQR 2.7-33.9]: three had levels more than 100 pmol/L. Conclusions: This study reports serum estriol concentrations in a large number of "new" and "chronic users" of vaginal estriol cream, employing a novel highly sensitive and specific technique. Overall, the results are reassuring: 87% had 12-hour estriol levels less than 100 pmol/L. K E Y W O R D S quantitative liquid chromatography tandem mass spectrometry, serum estriol concentrations, vaginal estriol cream Preliminary data were presented at the Urogynaecological Society of Australasia, and the International Continence Society annual scientific meetings in

The association between nocturia, hormonal symptoms and bladder parameters in women: an observational study

“…It is recognised that the genitourinary syndrome of menopause includes urinary frequency, nocturia, urinary urgency, stress incontinence and urinary tract infections, and that treatments can improve function and quality of life 7,22 . In this study, women who reported using either systemic HRT (8%) or vaginal oestrogen (36%) were not protected from bothersome nocturia, both therapies failing to demonstrate a significant association with nocturia frequency by either self‐report or bladder diary entry.…”

“…However, this was not a cross‐sectional study, nor did it collect adherence to regular use of either hormonal supplementation, and therefore the impact of either therapy could not be evaluated. Given that vaginal oestrogen over the long term has been shown to have a low‐risk profile, 22 research into its role in overall management of nocturia in postmenopausal women is justified.…”

Russian Eligibility Criteria Prescribing Menopausal Hormonal Hormones Therapy for Patients With Cardiovascular and Metabolic Diseases. Consensus Document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russia

“…Это предупреждение основано не на данных научных исследований, а связано с международными требованиями обязательного указания единых противопоказаний для препарата, независимо от путей его введения [45]. Эстриол при локальном применении имеет минимальную системную абсорбцию и не метаболизируется в более активные формы эстрогенов (эстрадиол и эстрон), а уровни циркулирующего эстриола, эстрадиола и эстрона сохраняются в пределах нормальных значений для постменопаузы [57] [58]. Несколько крупных обсервационных исследований подтвердили отсутствие повышенного риска неблагоприятных последствий для здоровья, включая ССЗ, ВТЭО и рак при использовании локальной МГТ эстриолом [59] [60].…”

Russian Eligibility Criteria for Prescribing Menopausal Hormone Therapy to Patients With Cardiovascular and Metabolic Diseases. Consensus Document of RSC, RSOG, RAE, EUAT, RAP

“…Это предупреждение основано не на данных научных исследований, а связано с международными требованиями обязательного указания единых противопоказаний для препарата, независимо от путей его введения [45]. Эстриол при локальном применении имеет минимальную системную абсорбцию и не метаболизируется в более активные формы эстрогенов (эстрадиол и эстрон), а уровни циркулирующего эстриола, эстрадиола и эстрона сохраняются в пределах нормальных значений для постменопаузы [56,57]. Несколько крупных обсервационных исследований подтвердили отсутствие повышенного риска неблагоприятных последствий для здоровья, включая ССЗ, ВТЭО и рак, при использовании локальной МГТ эстриолом [58,59].…”