Ultra-Low-Dose Estriol Gel Cuts UTIs by 26% in Postmenopausal Women with Genitourinary Syndrome of Menopause
A recent study highlighted the potential of the ultra-low-dose estriol gel to improve vaginal health in postmenopausal women by normalizing pH, reducing susceptibility to uropathogens, and minimizing estrogen exposure while maintaining efficacy.
This randomized, double-blind, placebo-controlled, multicenter clinical trial assessed the efficacy of a 0.005% ultra-low-dose estriol vaginal gel in preventing recurrent urinary tract infections (UTIs) in postmenopausal women with genitourinary syndrome of menopause (GSM). Conducted across 28 Spanish sites, 108 postmenopausal women were randomized to receive either the estriol gel or a placebo moisturizing gel for 24 weeks.
Results showed a 26% reduction in UTI incidence in the estriol group compared with placebo (32.34 vs. 43.76 cases per 100 women-years, P < 0.001). Additionally, estriol gel improved vaginal pH and reduced asymptomatic bacteriuria and unscheduled clinic visits related to UTIs. Most participants in the estriol group (86.8%) reported no UTI episodes during treatment. The estriol gel was well tolerated, with fewer adverse events reported compared to the placebo group (17.5% vs. 27.6%). Compliance rates were higher in the estriol arm, and patients reported high treatment acceptability.
Limitations included the absence of a validated tool for assessing urinary symptoms and the short follow-up period (24 weeks). Future studies are needed to evaluate long-term efficacy and safety.
“Our results provide clinical evidence on the efficacy and safety of an ultra-low dose 0.005 % estriol vaginal gel in preventing recurrent UTIs in postmenopausal women with GSM, reducing the incidence and potentially decreasing the susceptibility to urogenital infections improving the altered vaginal pH,” the study authors concluded.
Reference
Muiños Fernández N, Martínez Salamanca JI, Pardo González de Quevedo JI, et al. Efficacy and safety of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause: A randomized double-blind placebo-controlled trial. Maturitas. 2024;190:108128. doi:10.1016/j.maturitas.2024.108128