Date of Award
Spring 5-2025
Document Type
Scholarly Project
Degree Name
Master of Physician Assistant Studies (MPAS)
Department
Physician Assistant Studies
First Advisor
McHugo, Jeanie
Keywords
menopause, urogenital atrophy, vaginal atrophy, estrogen therapy, local therapy, symptomatic menopause, hormone replacement therapy, HRT, cream, gel, ring, preference
Abstract
Menopause is a natural, nonpathological event that occurs due to decreasing estrogen levels that may be achieved naturally or through surgical means. One of the most commonly reported and often painful symptoms of menopause is urogenital atrophy, also known as vaginal atrophy. Symptoms include vaginal pruritus, dyspareunia, dryness, vaginal irritation, dysuria, and tightness associated with thinning and reduced elasticity of the vaginal mucosa. These symptoms can negatively impact the quality of life. Local estrogen therapy is the preferred treatment option due to its minimal systemic absorption, potential as a safe option for menopausal patients with hormone-sensitive conditions, and ease of adjusting the dose depending on the symptom severity. The purpose of this literature review is to compare two common delivery methods, estrogen creams or gels versus the estrogen ring, to determine the most preferred and effective approach for symptom relief. Findings from the articles show that while all local estrogen therapies offer symptom relief, the estrogen ring promotes better patient adherence and satisfaction due to convenience and lower maintenance. Future research could explore the comparative safety and efficacy of local versus systemic hormone replacement therapy, as well as alternative delivery methods such as local estrogen pellets or menopause-specific IUDs. Additionally, studies focusing on the ease of local estrogen administration for patients with mobility issues, such as arthritis or neurological conditions, could provide valuable insight. Results of future studies could support personalized treatment options for menopausal patients seeking effective, localized treatments for vaginal atrophy.
Recommended Citation
Burkman, Clara, "Comparative Efficacy and Preference of Estrogen Cream or Gel vs. Vaginal Ring Estrogen for Hormone Replacement Therapy in Menopausal Individuals" (2025). Physician Assistant Scholarly Project Papers. 223.
https://commons.und.edu/pas-grad-papers/223