Da Silva Ana Sofia, O'Kane Miriam, Davis Cathy, Rantell Angie, Araklitis George, Robinson Dudley
Department of Urogynaecology, King's College Hospital, London, UK.
Climacteric. 2025 Oct;28(5):537-544. doi: 10.1080/13697137.2025.2473431. Epub 2025 Mar 14.
Environmental consciousness and the role of plastic waste are increasing. Topical vaginal estrogen prescription can be prescribed with one reusable plastic applicator or multiple single-use plastic applicators. User preference about the role of plastic in personal healthcare is not fully understood. This study aimed to explore patients' perspectives on the applicator and environmental considerations.
A mixed-methods questionnaire was employed to assess users' experience with topical vaginal estrogen applicators and their views on the environment.
Ninety-two respondents had previously used estriol 0.1% cream and 77 had used estradiol 10 μg vaginal inserts. The mean age of participants was 67.3 years. The mean duration of use was 36.5 months, and the discontinuation rate was 26.1% and 29.9% for estriol 0.1% cream and estradiol 10 μg vaginal insert users, respectively. Satisfaction with applicators and ease of use were similar in both groups. There was a higher report of the product being 'messy' (38.0% vs. 18.2%; = 0.026) and 'not hygienic' (48.9% vs. 18.2%; < 0.001) by estriol 0.1% cream users compared to estradiol 10 μg vaginal insert users. Women aged <65 years demonstrated a greater concern about plastic use and the impact on the environment compared to women aged over 65 years (81.0% vs. 56.9%; = 0.002). The younger cohort showed a preference for reusable applicators (66.2%) compared to single-use applicators (33.8%) ( 0.005). There was no statistically significant difference in preference for women aged over 65 years.
This study demonstrates that younger postmenopausal women showed greater concern for plastic waste and its impact on the environment, with a preference for reusable products. Manufacturers of health products and prescribers should be aware of this growing trend. With similar overall satisfaction and side-effect profiles, users should be made aware of the different types of applicators available to help support an informed decision.
环境意识及塑料垃圾的影响日益受到关注。局部阴道雌激素处方可以使用一个可重复使用的塑料涂抹器或多个一次性塑料涂抹器开具。使用者对于塑料在个人医疗保健中的作用的偏好尚未得到充分了解。本研究旨在探讨患者对涂抹器的看法以及对环境因素的考量。
采用混合方法问卷来评估使用者使用局部阴道雌激素涂抹器的体验及其对环境的看法。
92名受访者曾使用过0.1%雌三醇乳膏，77名曾使用过10μg雌二醇阴道栓剂。参与者的平均年龄为67.3岁。平均使用时长为36.5个月，0.1%雌三醇乳膏使用者和10μg雌二醇阴道栓剂使用者的停药率分别为26.1%和29.9%。两组对涂抹器的满意度及使用便利性相似。与10μg雌二醇阴道栓剂使用者相比，0.1%雌三醇乳膏使用者中报告产品“易洒落”（38.0%对18.2%；P = 0.026）和“不卫生”（48.9%对18.2%；P < 0.001）的比例更高。与65岁以上女性相比，65岁及以下女性对塑料使用及其对环境的影响更为关注（81.0%对56.9%；P = 0.002）。较年轻的人群更倾向于可重复使用的涂抹器（66.2%）而非一次性涂抹器（33.8%）（P = 0.005）。65岁以上女性在偏好上无统计学显著差异。
本研究表明，绝经后年轻女性对塑料垃圾及其对环境的影响更为关注，更倾向于可重复使用的产品。健康产品制造商和开处方者应意识到这一不断增长的趋势。鉴于总体满意度和副作用情况相似，应让使用者了解可用的不同类型涂抹器，以帮助他们做出明智的决定。
