RESUMEN
Hormone therapy was considered the standard of care before the publication of the Women's Health Initiative. After the study was published, the use of systemic hormone therapy dramatically decreased resulting in an increased incidence of menopausal symptoms such as hot flashes, vaginal dryness, and dyspareunia experienced by women. Use of vaginal estrogen offers women a unique alternative for relief of these symptoms. This article reviews the systemic effects of vaginally administered estrogen. Effects on serum hormone levels, vasomotor symptoms, lipid profiles, and use in women with breast cancer are reviewed. An accompanying review (J Pelvic Med Surg. 2009;15:105-114.) examines the local effects of vaginally administered estrogen.
RESUMEN
The results of the Women's Health Initiative (WHI) led to a distinct decline in the routine use of estrogen as preventive therapy for vasomotor symptoms, osteoporosis, and cardiovascular disease in postmenopausal women. Without estrogen replacement, one third of women experience symptoms of atrophic vaginitis including dryness, irritation, itching and or dyspareunia. Local application of estrogen has been shown to relieve these symptoms and improve quality of life for these women. In addition, local estrogen therapy may have a favorable effect on sexuality, urinary tract infections, vaginal surgery, and incontinence. This review examines the effects of vaginally applied estrogen on the vaginal epithelium, urethra and endometrium. An accompanying review examines the systemic effects of vaginally applied estrogen.
