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Local Oestrogen for Pelvic Floor Disorders: A Systematic Review
M A Weber1, M H Kleijn1, M Langendam2
1Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands.
Plos One
|September 19, 2015
Summary
Local estrogen therapy effectively treats vaginal atrophy (VA) and may reduce symptoms of overactive bladder (OAB) and urinary incontinence (UI) in postmenopausal women. Further research is needed for pelvic organ prolapse (POP).
Area of Science:
- Gynecology
- Urogynecology
- Menopause Research
Background:
- Menopause-related oestrogen decline is linked to pelvic floor disorders.
- Conditions include vaginal atrophy (VA), urinary incontinence (UI), overactive bladder (OAB), and pelvic organ prolapse (POP).
Purpose of the Study:
- To systematically review evidence on local oestrogen therapy for treating menopausal pelvic floor disorders.
- Evaluate efficacy for VA, UI/OAB, and POP.
Main Methods:
- Systematic search of major databases (MEDLINE, EMBASE, Cochrane, PubMed) up to May 2014.
- Included randomized controlled trials (RCTs) for VA and UI/OAB, and all studies for POP.
- Independent data extraction and risk of bias assessment.
Main Results:
- Topical oestrogens improved subjective and urodynamic outcomes, vaginal maturation, and pH compared to placebo.
- Low doses showed benefit; application methods did not significantly differ.
- Evidence for POP treatment is limited, often focusing on associated VA symptoms.
Conclusions:
- Local oestrogen therapy is effective for vaginal atrophy (VA).
- It appears beneficial for overactive bladder (OAB) and urinary incontinence (UI) symptoms.
- More research is required to establish the role of local oestrogens in pelvic organ prolapse (POP) prevention and treatment.
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