A COMPARATIVE MULTICENTER STUDY OF THE EFFECTS OF CONTINUOUS LOW-DOSEESTRADIOL RELEASED FROM A NEW VAGINAL RING VERSUS ESTRIOL VAGINAL PESSARIES IN POSTMENOPAUSAL WOMEN WITH SYMPTOMS AND SIGNS OF UROGENITAL ATROPHY

OBJECTIVE: Our purpose was to study the efficacy, safety, and acceptab ility of a new estradiol-releasing (6.5 to 9.5 mu g per 24 hours) sili cone rubber vaginal ring compared with Ovesterin 0.5 mg estriol vagina l pessaries. STUDY DESIGN: Gynecologic clinical status, vaginal pH, cy tologic characteristics, and occurrence of bacteriuria were determined before starting and after 3 and 12 weeks of treatment in 146 postmeno pausal women. RESULTS: Both treatments alleviated the subjective and o bjective symptoms of estrogen deficiency excellently, and both were eq ually effective at restoring the vaginal pH to levels normally seen in fertile women (< 5.5). Vaginal cytologic studies showed a significant difference in maturation value in favor of the estradiol-releasing si licone rubber vaginal ring, as measured by the pathologist's assessmen t of the proliferation of the vaginal mucosa. A total of 77% of users were classified as responders, compared with 39% in the pessary group. Both treatments were well accepted. The administration of the pessary was associated with a significantly higher (p < 0.001) incidence of d iscomfort than that of the ring, which was given better (p < 0.001) ra ting by the patients at the 12-week visit. A strong preference (p < 0. 001) for the ring was shown by patients with previous experience with pessaries. CONCLUSION: Treatment of urogenital symptoms in postmenopau sal women with an estradiol-releasing vaginal ring is shown to be an e ffective and safe method, exhibiting advantages over treatment with es triol vaginal pessaries.