Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: A preliminary study

Nicoletta Biglia, Elisa Peano, Paola Sgandurra, Giulia Moggio, Enrico Panuccio, Marco Migliardi, Nicoletta Ravarino, Riccardo Ponzone, Piero Sismondi

Research output: Contribution to journalArticlepeer-review


The study aim is to evaluate the efficacy and safety of two low-dose vaginal estrogen treatments (ETs) and of a non-hormonal vaginal moisturizer in postmenopausal breast cancer survivors with urogenital atrophy. Eighteen patients receiving estriol cream 0.25mg (n=10) or estradiol tablets 12.5μg (n=8) twice/week for 12 weeks were evaluated and compared with eight patients treated with polycarbophil-based moisturizer 2.5g twice/week. Severity of vaginal atrophy was assessed using subjective [Vaginal Symptoms Score (VSS), Profile of Female Sexual Function (PFSF)] and objective [Vaginal Health Index (VHI), Karyopycnotic Index (KI)] evaluations, while safety by measuring endometrial thickness and serum sex hormones levels. After 4 weeks, VSS and VHI were significantly improved by both vaginal ETs, with further improvement after 12 weeks. PFSF improved significantly only in estriol group (p=0.02). Safety measurements did not significantly change. Vaginal moisturizer improved VSS at week 4 (p=0.01), but score returned to pre-treatment values at week 12; no significant modification of VHI, KI, PFSF was recorded. Both low-dose vaginal ET are effective for relieving urogenital atrophy, while non-hormonal moisturizer only provides transient benefit. The increase of serum estrogens levels during treatment with vaginal estrogen at these dosages is minimal.

Original languageEnglish
Pages (from-to)404-412
Number of pages9
JournalGynecological Endocrinology
Issue number6
Publication statusPublished - Jun 2010


  • Breast cancer survivors
  • Low-dose vaginal estrogens
  • Urogenital atrophy
  • Vaginal moisturizer

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Obstetrics and Gynaecology


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