Clinical Edge

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IVT or Vaginal Ring for Vaginal Dryness

JAMA Oncol; ePub 2016 Nov 10; Melisko, et al

Treatment with a vaginal ring or intravaginal testosterone cream (IVT) in postmenopausal women with early-stage breast cancer (BC) receiving aromatase inhibitors (AIs) over 12 weeks is safe, with vaginal atrophy, sexual interest, and sexual dysfunction improved, a recent study found. Postmenopausal women with hormone receptor (HR)-positive stage I to III BC taking AIs with self-reported vaginal dryness, dyspareunia, or decreased libido were randomized to 12 weeks of IVT or an estradiol vaginal ring. Researchers found:

  • 75 women (mean age 56 years) started treatment; 69 completed 12 weeks of treatment.
  • Mean (range) baseline elevation in estradiol (E2) was 20 (<2 to 127) pg/mL.
  • At baseline, E2 was above the postmenopausal range in 28 of 76 (37%) women.
  • Persistent E2 elevation was observed in none with a vaginal ring and in 4 of 34 (12%) women with IVT.
  • Transient E2 elevation was observed in 4 of 35 (11%) with a vaginal ring and in 4 of 34 (12%) with IVT.
  • Vaginal atrophy and sexual interest and dysfunction improved for all patients.

Citation:

Melisko ME, Goldman ME, Hwang J, et al. Vaginal testosterone cream vs estradiol vaginal ring for vaginal dryness or decreased libido in women receiving aromatase inhibitors for early-stage breast cancer. A randomized clinical trial. [Published online ahead of print November 10, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.3904.