From the Guidelines
Estrogen vaginal rings are a safe and effective treatment option for elderly women experiencing vaginal atrophy and urogenital symptoms related to menopause, as evidenced by a study published in 2024 1. The use of estrogen vaginal rings in elderly women has been shown to improve vaginal atrophy and sexual function, with minimal systemic absorption 1. Key benefits of estrogen vaginal rings for elderly women include:
- Improved vaginal tissue health
- Reduced symptoms of vaginal dryness, burning, itching, and painful intercourse
- Decreased risk of urinary tract infections
- Convenient administration, with replacement required only every three months
- Low dose of estrogen, primarily delivered to vaginal tissues with minimal systemic absorption However, healthcare providers should consider contraindications such as history of breast cancer, estrogen-dependent tumors, undiagnosed vaginal bleeding, or history of thromboembolism before prescribing 1. A study of 76 postmenopausal survivors of hormone receptor (HR)–positive breast cancer receiving aromatase inhibitor (AI) therapy found that an estradiol-releasing vaginal ring was safe and improved vaginal atrophy and sexual function 1. Additionally, a large cohort study of almost 50,000 patients with breast cancer followed for up to 20 years showed no evidence of a higher risk of breast cancer–specific mortality in those using vaginal estrogen 1. Regular follow-up appointments every 6-12 months are recommended to assess effectiveness and monitor for any adverse effects.
From the Research
Estrogen Vaginal Rings in Elderly
- There is no direct evidence in the provided studies regarding the use of estrogen vaginal rings in elderly women.
- However, the studies discuss the use of estrogen therapy and other treatments for vaginal atrophy and dryness in postmenopausal women, which may be relevant to elderly women experiencing similar symptoms 2, 3, 4, 5, 6.
- Estrogen therapy is indicated for symptoms related to the vagina, bladder, and bones in women over 60, but it is essential to ensure that these symptoms are directly related to estrogen deprivation and not the aging process 2.
- Ospemifene, a selective estrogen receptor modulator, has been shown to be effective in treating vaginal dryness and other symptoms of vulvovaginal atrophy in postmenopausal women, with a favorable safety profile 3, 4, 5, 6.
- The use of estrogen vaginal rings or other local estrogen therapies may be considered for elderly women with vaginal atrophy or dryness, but the provided studies do not specifically address this topic.
- Further research would be needed to determine the safety and efficacy of estrogen vaginal rings in elderly women.