Improved compliance and patient satisfaction with estradiol vaginal tablets in postmenopausal women previously treated with another local estrogen therapy

Mary Jane Minkin, Ricardo Maamari, Suzanne Reiter, Mary Jane Minkin, Ricardo Maamari, Suzanne Reiter

Abstract

Up to half of all postmenopausal women will experience changes in the genitourinary tract induced by the hypoestrogenic state, collectively known as vaginal atrophy. Vaginally administered local estrogen therapy (LET) is the standard of care for symptoms of vaginal atrophy that do not respond to nonhormonal interventions. Several LET formulations are available, and choice of therapy is based largely on patient needs and preferences. This online survey of postmenopausal LET users was conducted to investigate reasons for switching to vaginal estradiol tablets from other formulations and to evaluate factors associated with patient preference for and compliance with use of LET. Data was analyzed from 73 respondents currently using estradiol vaginal tablets who have previously used the estradiol vaginal ring, estradiol vaginal cream, and/or conjugated estrogen vaginal cream. Patients in this survey rated vaginal symptoms of vaginal atrophy as being more bothersome than urinary symptoms. Respondents preferred their current treatment with the vaginal tablet to their previous treatment with a cream or ring. The preference for tablets over creams was mainly related to formulation and application rather than to any perceived safety issues. Tablets were perceived as efficacious, convenient, and neat to apply. The study participants also reported a longer duration of tablet use compared with creams or rings, and greater compliance with vaginal tablets than with vaginal cream. This study provides new insights into reasons for patient noncompliance with estrogen cream or ring therapy that can be used to maximize patient adherence with LET.

Keywords: conjugated estrogen vaginal cream; estradiol; local estrogen therapy; vaginal atrophy; vaginal cream; vaginal ring; vaginal tablet.

Figures

Figure 1
Figure 1
Symptoms of vaginal atrophy considered bothersome by patients, according to age group. Notes: *Vaginal itchiness: older versus younger (P = 0.0345). **Vaginal soreness: older versus younger (P = 0.0492). Abbreviation: UTIs, urinary tract infections.
Figure 2
Figure 2
Reasons for switching from vaginal cream to vaginal tablet.
Figure 3
Figure 3
User-friendliness ratings of the different local estrogen therapy formulations.
Figure 4
Figure 4
Positive attributes of vaginal estradiol tablets.

References

    1. MacBride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010;85(1):87–94.
    1. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician. 2000;61(10):3090–3096.
    1. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. Menopause. 2007;14(3 Pt 1):355–369.
    1. Lara LA, Useche B, Ferriani RA, et al. The effects of hypoestrogenism on the vaginal wall: interference with the normal sexual response. J Sex Med. 2009;6(1):30–39.
    1. Avis NE, Brockwell S, Randolph JF, Jr, et al. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women’s Health Across the Nation. Menopause. 2009;16(3):442–452.
    1. Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause. 2008;15(4 Pt 1):661–666.
    1. Wyeth. REVEAL Revealing Vaginal Effects At Mid-Life: Surveys of postmenopausal women and health care professionals who treat postmenopausal women. [Accessed April 6, 2012]. Available from: .
    1. Nappi RE, Kokot-Kierepa M. Women’s voices in the menopause: results from an international survey on vaginal atrophy. Maturitas. 2010;67(3):233–238.
    1. The North American Menopause Society. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. Menopause. 2007;14(3):357–369.
    1. Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–522.
    1. Kingsberg S, Kellogg S, Krychman M. Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy. Int J Womens Health. 2010;1:105–111.
    1. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2006;4:CD001500.
    1. Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med. 2009;6(8):2133–2142.
    1. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views and Attitudes (VIVA) – results from an international survey. Climacteric. 2012;15(1):36–44.
    1. Shulman LP, Portman DJ, Lee WC, et al. A retrospective managed care claims data analysis of medication adherence to vaginal estrogen therapy: implications for clinical practice. J Womens Health (Larchmt) 2008;17(4):569–578.
    1. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views and Attitudes (VIVA) - results from an international survey. Climacteric. 2012;15(1):36–44.
    1. Rioux JE, Devlin C, Gelfand MM, Steinberg WM, Hepburn DS. 17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis. Menopause. 2000;7(3):156–161.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera