Vaginal administration of low-dose conjugated estrogens: Systemic absorption and effects on the endometrium

Victoria L. Handa, Kevin E. Bachus, William W. Johnston, Stanley J. Robboy, Charles B. Hammond

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Objective: To test the hypothesis that a very-low-dose regimen of vaginal estrogen would provide effective relief from atrophic vaginitis without endometrial proliferation. Methods: Twenty postmenopausal women with symptoms, signs, and cytologic evidence of atrophic vaginitis were enrolled. Each subject was treated with 0.3 mg of conjugated estrogens, administered vaginally 3 nights per week for 6 months. We examined the following outcomes: symptoms, vaginal cellular (cytologic) maturity, endometrial histology, sonographic evaluation of endometrial thickness, Doppler measures of uterine artery blood flow, and serum levels of estrone and estradiol. Pre- and post treatment data were compared for each subject. Results: Satisfactory relief of symptoms occurred in 19 of 20 cases. Vaginal cellular maturation improved significantly with therapy (P <.01). There were no significant changes in endometrial thickness, uterine artery blood flow, or serum estrogen levels. Endometrial proliferation was observed in one case. Conclusions: Relief from atrophic vaginitis can be achieved with 0.3 mg of conjugated estrogens administered vaginally three times per week. Endometrial proliferation may occur at this low dose, albeit rarely.

Original languageEnglish (US)
Pages (from-to)215-218
Number of pages4
JournalObstetrics and gynecology
Issue number2
StatePublished - Aug 1994
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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