Tontivuthikul Paponrad, Sanmee Usanee, Wongtra-Ngan Supreeya, Pongnarisorn Chailert
J Med Assoc Thai. 2016 Jul;99(7):757-63.
Currently, there is no evidence whether local estrogen cream should always be used in conjunction with a pessary as atrophic prevention. There is still no consensus about the long-term safety of local estrogen cream. Therefore, it is recommended to use hormone for the shortest duration as possible.
Evaluate the effect of local estrogen cream on vaginal health in pessary use for pelvic organ prolapse.
Forty postmenopausal women with pelvic organ prolapse who had used a pessary in conjunction with local estrogen cream for six weeks were randomly selected to use vaginal conjugated equine estrogen (CEE) cream 0.5 g once a week (treatment group) or no treatment (control group) for 24 weeks. The primary outcome was vaginal health assessment composed of vaginal symptom score, vaginal pH, and vaginal maturation index. The secondary outcome measures were the difficulty to use pessary and the endometrial thickness.
No statistical differences were found for all vaginal health assessment at baseline, 12, and 24 weeks among the treatment and the control groups. There was also no significant difference between the groups about the difficulty to insert and remove the pessary or the endometrial thickness.
Vaginal CEE cream 0.5 g once a week did not show any additional positive effect on vaginal health in pessary use.
目前，尚无证据表明局部雌激素乳膏是否应始终与子宫托联合使用以预防萎缩。关于局部雌激素乳膏的长期安全性仍未达成共识。因此，建议尽可能缩短激素使用时间。
评估局部雌激素乳膏对盆腔器官脱垂使用子宫托时阴道健康的影响。
随机选取40名使用子宫托联合局部雌激素乳膏六周的绝经后盆腔器官脱垂女性，分为两组，一组每周使用一次0.5g阴道结合雌激素（CEE）乳膏（治疗组），另一组不进行治疗（对照组），持续24周。主要结局是由阴道症状评分、阴道pH值和阴道成熟指数组成的阴道健康评估。次要结局指标是使用子宫托的困难程度和子宫内膜厚度。
治疗组和对照组在基线、12周和24周时的所有阴道健康评估均无统计学差异。两组在插入和取出子宫托的困难程度或子宫内膜厚度方面也无显著差异。
每周一次0.5g阴道CEE乳膏对使用子宫托时的阴道健康未显示出任何额外的积极作用。
