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Unlabelled: Estrogen replacement therapy is used in postmenopausal women with symptoms of urogenital atrophy. The aim of this study was to detect differences in efficacy of a low-dose estradiol-releasing vaginal ring and a placebo ring in the relief of symptoms of estrogen deficiency and reduction of urogenital atrophy (pH and vaginal mucosal maturation) in postmenopausal women., Design: This was a multicentre double-blind, placebo-controlled study., Patient Sample: 84 postmenopausal women, of whom 67 completed the full 24 weeks of treatment., Results: Vaginal pH decreased significantly (p = 0.0006) in the estradiol group compared with the placebo group. Similarly, in the estradiol group the mean maturation value increased significantly (p = 0.0004), while incidence of pallor and friability were significantly reduced. Patients in the estradiol group reported significantly greater relief of dyspareunia., Conclusion: The results indicate that the estradiol-releasing vaginal ring is effective and well tolerated in the treatment of local estrogen deficiency.

Objective: Our purpose was to compare the effects of a new estradiol-releasing vaginal ring with progesterone given as a vaginal suppository, versus the efficacy, safety and acceptability of an intrauterine device releasing levonorgestrel combined with estradiol, delivered transdermally from a patch. Climacteric symptoms, bleeding pattern and endometrial histologic features were studied., Methods: Fifty six parous, postmenopausal women with urogenital symptoms were allocated in two groups for one year: 28 women receiving estradiol by a vaginal ring and a 100 mg vaginal progesterone suppository 7 days every month and 28 women receiving a continuous transdermal daily dose of 50 micrograms of estradiol with a levonorgestrel-releasing intrauterine device inserted. All the patients were subjected to vaginosonographic examination followed by thorough pathological examination of the uterine curetting samples., Results: A mean endometrial thickness (double layer) of 2.9 and 3.0 mm, respectively, was found to be predictive of normal endometrium. Both treatment regiments effectively relieved climacteric symptoms. Endometrial proliferation was not observed. Spotting was more common in the intrauterine device group than in the vaginal ring group., Conclusions: Treatment of urogenital symptoms in postmenopausal women with these two forms of hormone replacement therapy is shown to be an effective and safe method, exhibiting advantages over other methods of treatment.