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Local Estrogen Adherence: A Prospective Pilot Study.

Feven W Getaneh1, Jon F Pennycuff2, Hannah Kelly3

  • 1Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Journal of Women'S Health (2002)
|July 30, 2025
PubMed
Summary
This summary is machine-generated.

Local estrogen therapy (LET) improves vaginal and pelvic floor symptoms. Adherence challenges, including cost and side effects, can be addressed by healthcare providers to enhance treatment continuation.

Keywords:
climactericestrogen replacementmenopausepelvic floor disorderstreatment adherence

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Area of Science:

  • Gynecology
  • Urology
  • Women's Health

Background:

  • Local estrogen therapy (LET) offers significant benefits for various gynecological and urological conditions.
  • Adherence and reasons for discontinuing LET are not well-understood, impacting long-term treatment effectiveness.

Purpose of the Study:

  • To evaluate the fill and continuation rates of local estrogen therapy (LET).
  • To identify factors associated with not filling or discontinuing LET among adult women.

Main Methods:

  • A prospective observational study involving 155 adult women newly prescribed LET.
  • Participants completed validated questionnaires (PFDI-20, DIVA) at baseline and 3-, 6-, and 12-month intervals.
  • Reasons for discontinuation were collected from participants who stopped LET.

Main Results:

  • High initial prescription fill rate (94%) and good continuation rates at 3 (78%), 6 (90%), and 12 months (79%).
  • Significant loss to follow-up (60%) was observed over the 12-month study period.
  • Primary reasons for not starting LET included cost (33%) and side effect concerns (22%); discontinuation reasons were messiness (19%) and side effects (16%).
  • LET use was associated with improved pelvic floor and vaginal symptoms, irrespective of continuation status.

Conclusions:

  • Local estrogen therapy demonstrates efficacy in improving pelvic floor and vaginal symptoms up to 12 months.
  • High loss to follow-up presents a challenge for prospective evaluation of LET adherence.
  • Addressing barriers like cost, messiness, and side effect concerns can potentially improve LET adherence and patient outcomes.