Ovestin vaginal cream and suppositories for the treatment of menopausal vaginal atrophy

Eighty-two postmenopausal women with vaginal atrophy and associated symptoms were treated with either Ovestin vaginal cream (54 women) or vaginal suppositories (28 women) containing 0.5 mg of E3/dose, daily for 3 weeks. A maintenance dose of 0.5 mg of E3 twice weekly was applied by all patients for 5 weeks, and by 27 of them for up to 16 weeks. Variables studied were clinical and colposcopic findings, the Maturation Index (MI) and Maturation Value (MV), cervical mucus ferning (F) and spinnbarkeit (S) and endometrial biopsies (obtained pretreatment and after 3 weeks in 15 of the patients). Furthermore, the bio-availability of circulating unconjugated E3 for up to 8 hours following a single dose of Ovestin cream was studied in 10 of the patients. Clinical and colposcopic findings indicated that the treatment had a very favourable effect in all patients. This was reflected in the pronounced change in vaginal smears, indicating a strong oestrogenic effect. There was a slight to moderate effect on cervical mucus. Endometrial biopsies showed that endometrium remained atrophic in all 15 patients in whom biopsies were obtained. A maintenance dose of 0.5 mg of E3 twice weekly appeared to be sufficient to maintain the beneficial effect. Tolerance was good, and patients commented favourably on the treatment.