Estradiol vaginal ring effectively relieves OAB in postmenopausal women

An ultralow-dose estradiol vaginal ring reduces voiding frequency as effectively as the oral anticholinergic oxybutynin in postmenopausal women with overactive bladder (OAB), researchers at the University of Southern California (Los Angeles) report.

Fifty-four women were randomized to receive oxybutynin 5 mg twice daily or a vaginal ring that released 7.5 μg of 17-β estradiol daily. All were postmenopausal as defined by no menstrual bleeding for longer than 1 year or having a level of follicle-stimulating hormone higher than 25 mU/mL in those who had undergone hysterectomy. After 12 weeks of treatment, the mean number of daily voids decreased significantly in both groups: from 14.7 to 11.7 (P=.003) in the oxybutynin group and from 14.9 to 10.4 (P

The study was published online April 26 in Menopause.

“The ultralow-dose estradiol-releasing vaginal ring and oral oxybutynin seem to have similar efficacies in reducing urinary frequency episodes and improving incontinence-related quality of life in postmenopausal women with OAB,” the authors conclude. The vaginal ring “might therefore be an effective and well-tolerated alternative to anticholinergic treatment of OAB in postmenopausal women,” they write.

Eighty-five percent of women receiving oxybutynin reported dry mouth, compared with 22% of women with the vaginal ring; constipation rates were 52% with oxybutynin and 7% with the ring. Significantly more women with the ring reported vaginal discharge (41%) than did the women taking oxybutynin (4%).

When study participants were asked whether they wanted to continue treatment after the trial was over, 85% of women in the vaginal ring group said they wanted to continue that therapy compared with 59% of the oxybutynin group.