Vaginal atrophy

Reduction in physcat symptoms of menopause hot flushes night sweats headaches heart palpitations dizziness vaginal atrophy, and tinnitus (ringing in the ears)... 

Utian WH, Shoupe D, Backmann G, et al. Relief of vasomotor symptoms and vaginal atrophy with lower doses of conjugated equine estrogens and medroxyprogesterone acetate. Fertil Steril 2001 75 1065-1079. 

Moderate to severe vasomotor symptoms, vulvar/vaginal atrophy associated with menopause - Initiate treatment at the lowest dose. Titrate to determine the minimal effective dose for maintenance therapy. Administer micronized estradiol cyclically (eg, 3 weeks on and 1 week off). Administer estradiol acetate once daily. 

Moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with menopause and female hypoestrogenism caused by hypogonadism, castration, or primary ovarian failure - 10 to 20 mg every 4 weeks. 

Moderate to severe vasomotor symptoms and/or moderate to severe symptoms of vulvar and vaginal atrophy associated with menopause - Start at the lowest dose. Therapy may be given continuously with no interruption, or in cyclical regimens (eg, 25 days on followed by 5 days off) as is medically appropriate on an individualized basis. 

Vulvar/Vaginal atrophy Treatment of urogenital symptoms associated with... 

Menopause and vulval/vaginal atrophy Reevaluate patients at 3- to 6-month intervals to determine the need for continued treatment. 

Consider topical products if treatment is solely for vulvar or vaginal atrophy... 

A very similar conclusion was reached In another study of a possible interaction between raloxifene 60 mg/day and a conjugated estrogen cream used locally to treat vaginal atrophy (35). 

Pinkerton JV, Shifren JL, La Valleur J, Rosen A, Roesinger M, Siddhanti S. Influence of raloxifene on the efficacy of an estradiol-releasing ring for treating vaginal atrophy in postmenopausal women. Menopause 2003 10 45-52. 

Parsons A, Merritt D, Rosen A, Heath III H, Siddhanti S, Plouffe L Jr. Effect of raloxifene on the response to conjugated estrogen vaginal cream or nonhormonal moisturizers in postmenopausal vaginal atrophy. Obstet Gynecol 2003 101 346-52. 

Tablets Tablets are single dose, solid preparations manufactured from compressing the active with a range of excipients into a specified shape HRT/vaginal atrophy...

Bygderman, M., and M.L. Swahn. 1996. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas 23 259. 

Due to the presence of oestrogens there is increased risk of breast, endometrial and ovarian cancer, venous thromboembolism and stroke, but they alleviate vaginal atrophy and vasomotor instability, and reduce osteoporosis. 

Crandall, C. (2002), Vaginal estrogen preparations A review of safety and efficacy for vaginal atrophy. /. Womens Health (Larchmt.), 11,857-877. 

Tibolone has combined estrogenic, progestogenic, and androgenic activity. Its effects depend on metabolism and activation in peripheral tissues. Tibolone has beneficial effects on mood and hbido and improves menopausal symptoms and vaginal atrophy. It protects against bone loss and reduces the risk of vertebral fractures. It reduces total cholesterol, triglyceride, lipoprotein (a), and, unfortunately, high-density lipoprotein concentrations. It may increase cardiovascular risk, breast cancer risk, and endometrial cancer risk. 

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