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-- Randomized controlled trials, although limited, have shown that low-dose, local vaginal estrogen delivery is effective and well tolerated for treating vaginal atrophy.
-- All the low-dose vaginal estrogen products approved in the United States for treatment of vaginal atrophy are equally effective at the doses recommended in labeling. Choice of therapy should be guided by clinical experience and patient preference.
-- Progestogen is generally not indicated when low-dose estrogen is used locally for vaginal atrophy.
-- Data are insignificant to recommend annual surveillance of the endometrium (lining of uterus) in asymptomatic women using vaginal estrogen.
-- Vaginal estrogen therapy should be continued for as long as symptoms that are distressing to the patient remain.
-- For women treated for non-hormone-dependent cancer, management of vaginal atrophy is similar to that for women without a cancer history.
-- For women with a history of hormone-dependent cancer, management recommendations are dependent upon each woman's preference in consultation with her oncologist.
The position statement is published in the May/June 2007 issue of the Society's official journal, Menopause. It has been designated a NAMS CME activity (print/online). A PDF of the paper, as well as a set of nine slides that summarize the paper's contents, are available without charge from the NAMS Web site (http://www.menopause.org/aboutmeno/consensus.htm).
NAMS is grateful to Novo Nordisk, Inc., for its educational grant that supported development of this statement.
The Mission of NAMS, a nonprofit scientific organization, is to
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