Menopause Clinical Trial
Official title:
The Vaginal Health Trial - Effects of Vaginal Estradiol Tablet and Moisturizing Gel on Postmenopausal Vaginal Symptoms
This is a new application from the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) Clinical Trials network. Here we propose to conduct a large multicenter trial comparing two common treatments, a vaginal hormone tablet and an over-the-counter gel, with placebo to evaluate their effects on bothersome vaginal symptoms and sexual function, and to create a biorepository of specimens for future translational, mechanistic research on the etiology of vaginal symptoms.
The Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) Clinical
Trials network was established in 2009. By the end of 2014, the network completed 4 clinical
trials testing 7 interventions in approximately 1000 women ages 40-62 with vasomotor (VMS)
and other menopause symptoms.
The current trial will evaluate a relatively understudied area of menopause - vaginal health
and sexual function. This is a 3-arm, randomized, controlled, double-blind, clinical trial
among postmenopausal women ages 45-70.
Our primary aim is to evaluate the effectiveness of ultra-low dose vaginal estradiol (Vagifem
10 mcg), non-hormonal hydrophilic non-prescriptive vaginal gel (Replens) and placebo in
reducing the Most Bothersome Symptom (MBS) severity. Choices for MBS include vulvovaginal
itching, pain, dryness, irritation, or pain with penetration.
Secondary aims include an evaluation of a composite score of vaginal symptoms, sexual
function, treatment satisfaction, menopause quality of life, and objective measures of
genitourinary atrophy. We will also create a biorepository of vaginal and blood specimens. In
a subset of women, we will examine whether treatment response is related to: a) the
post-menopausal vaginal microbiome; b) vaginal mucosal inflammation; and c) reproductive
hormone profiles. The in-depth focus on the mechanisms associated with postmenopausal vaginal
symptoms will use state of the art microbiologic techniques on longitudinally collected
biologic specimens and will guide future translational studies.
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