HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by FOSTER, D. C. Articles by MARKS, J. Search for Related Content PubMed PubMed Citation Articles by FOSTER, D. C. Articles by MARKS, J.

Effect of Vulvovaginal Estrogen on Sensorimotor Response of the Lower Genital Tract: A Randomized Controlled Trial

From the Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York; University of Maryland School of Nursing, Baltimore, Maryland; and The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Address reprint requests to: David C. Foster, MD, MPH Department of Obstetrics and Gynecology University of Rochester, PO Box 668 601 Elmwood Avenue Rochester, NY 14642 E-mail: dfoster{at}obgyn.rochester.edu

Objective: To assess the effect of vulvovaginal estrogen on mucocutaneous sensory threshold and circumvaginal motor strength.

Methods: Thirty-nine postmenopausal, hypoestrogenic women with mixed lower-genitourinary-tract complaints were placed in four masked treatment arms by permuted-block randomization for 6 weeks. One group received topical estradiol (E₂) cream and pelvic muscle biofeedback training, the second received topical cream and sham E₂ biofeedback, the third received placebo cream and pelvic muscle biofeedback training, and the fourth received placebo cream and sham biofeedback. Circumvaginal muscle strength was measured by averaging maximum intravaginal pressure (mmHg) generated over a set of four pelvic muscle contractions. Absolute changes in von Frey threshold (mN) and maximum intravaginal pressure (mmHg) over 4 and 6 weeks were reported as summary measures. Of 39 subjects, 30 completed the study.

Results: Topical estradiol cream significantly improved mechanical sensitivity of the vulvar vestibule to von Frey hairs, a -1.2-mN threshold decrease at 4 weeks (F = 10.29; P = .004), and a -1.6-mN threshold decrease at 6 weeks (F = 8.24; P = .009) compared with placebo cream. Stratification by age showed significantly greater improvement in mechanical sensitivity in the older (70–79 years) age group randomized to estrogen cream and a -5.49-mN threshold reduction (F = 17.65; P = .002). Maximum intravaginal pressures during circumvaginal muscle contraction did not differ between estrogen and placebo cream users (F = 0.00; P = .99).

Conclusion: Improved sensation to mechanical stimuli can result from a rapidly acting, direct effect of topical E₂ cream on the vulvar vestibule.

This article has been cited by other articles:

				M. A. Pessina, R. F. Hoyt Jr., I. Goldstein, and A. M. Traish Differential Effects of Estradiol, Progesterone, and Testosterone on Vaginal Structural Integrity Endocrinology, January 1, 2006; 147(1): 61 - 69. [Abstract] [Full Text] [PDF]

				Sexual Dysfunction Obstet. Gynecol., October 1, 2004; 104(4_suppl): 85S - 91S. [Full Text] [PDF]