Abstract:
Objective: To compare the effectiveness of estrogen cream using classical vaginal applicator versus extension tube vaginal applicator for the treatment of vaginal atrophy. Design: Randomized controlled trail. Setting: King Chulalongkorn Memorial Hospital, Thai Red Cross Society. Methods: A total of 120 postmenopausal women with vaginal atrophy were recruited. Patients were randomized into two groups: classical group (n=60) who used classical vaginal applicator and extension group (n=60) who used extension tube applicator. Partients in classical group received 1 gram of conjugated estrogen cream daily for 4 weeks and the other group received 1.1 grams of the same medication and period. Vaginal maturation index (VMI), vaginal atrophy score (VAS) were assessed. Number of days of use and patients' acceptability were recorded. Adverse events were also monitored. Results: Fifty seven patients in classical group and 58 in extension group completed the study. The mean of VMI was significantly increased in extension group more than classical group (p=0.007). The VAS was significantly improved in extension group more than classical group (p=0.009). The compliance with extension tube was significantly higher than classical vaginal applicator (p=0.008). Considering the acceptability and the occurrence of adverse events, there were no statistically significant differences between two groups. Conclusion: The effectiveness in the treatment of vaginal atrophy with estrogen cream was significantly higher when using extension tube than classical vaginal applicator. The compliance with extension tube was also higher than with classical vaginal applicator.
