Vaginal ultrasound of the endometrium in postmenopausal women with symptoms of urogenital atrophy on low-dose estrogen or tibolone treatment: A comparison

Objective: The objective of this study was to compare the efficacy of locally administered low-dose estrogens (0.625 mg of conjugated estrogens) and orally administered tibolone in postmenopausal women with symptoms and signs of atrophic vaginitis. Vaginal ultrasound was performed for the evaluation of endometrial or ovarian abnormalities. Methods: A 6-month comparative randomised prospective study of women taking tibolone and locally administered low-dose estrogens. Seventy two postmenopausal women with symptoms of atrophic vaginitis were examined with vaginal ultrasound. The endometrial thickness, the endometrial volume, the uterus and the ovaries were measured before and after 6 months of treatment with low-dose estrogens or tibolone. Results: In group A (low-dose estrogens treatment) the mean endometrial thickness, before and after treatment, was 3.0 +/- 0.1 mm and 2.9 +/- 0.8 mm, respectively The mean ovarian volume was 3.9 ml. There were no changes in uterine volume during the treatment period. In group B (treated with tibolone) endometrial thickness was 3.2 +/- 0.3 mm and 3.2 +/- 0.7 mm, respectively. One women experienced vaginal bleeding. The volume of corpus uteri was unchanged after treatment. The volume of both ovaries was 4.2 ml and 3.9 ml, respectively. The overall acceptability of both types of administration was good. Conclusions: This study, using vaginal ultrasound, has shown that either hormone replacement therapy with tibolone or symptomatic treatment with low-dose estrogens, gives no sign of endometrial proliferation measured as endometrial thickness. Copyright (C) 1997 Elsevier Science Ireland Ltd.