Many women find applying intravaginal estrogen cream to be messy and undesirable, even though it's a top treatment for recurrent urinary tract infections (UTIs) in postmenopausal women.This trial found that finger application of 0.5 g of estradiol cream to the periurethral area was noninferior to 1.0 g applied intravaginally with an applicator.Both study arms saw a decrease in vaginal pH at 6 months; the treatment works by promoting an acidic vaginal environment that protects against pathogens.
Periurethral application of a smaller amount of estradiol cream with a finger was noninferior to standard intravaginal application with an applicator among postmenopausal patients with recurrent urinary tract infections (UTIs), the TAPER randomized trial found.
At 6 months after starting treatment, 50.9% of patients randomized to periurethral estrogen were UTI-free compared with 52.6% of those randomized to intravaginal estrogen (risk difference -1.75 percentage points, 95% CI -20.0 to 17.0), reported Stephanie Zuo, MD, of the University of Virginia in Charlottesville, and colleagues.
Both study arms had a decrease in vaginal pH at 6 months, with a -1.2 decrease in the intravaginal group and a -0.8 decrease in the periurethral group (P=0.30), they wrote in Obstetrics & Gynecology.
