Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide

Angelica Lindén Hirschberg*, Johannes Bitzer, Antonio Cano, Iuliana Ceausu, Peter Chedraui, Fatih Durmusoglu, Risto Erkkola, Dimitrios G. Goulis, Ludwig Kiesel, Patrice Lopes, Amos Pines, Mick van Trotsenburg, Irene Lambrinoudaki, Margaret Rees

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Introduction: Vulvovaginal atrophy (VVA) is a chronic condition caused by estrogen deficiency. It affects around 50% of postmenopausal women, reducing their general and sexual quality of life as well as the quality of their personal relationships. Aim: The aim of this clinical guide is to set out an individualized approach to the management of VVA with topical estrogens and non-hormonal preparations. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: An individualized approach is required for the management of VVA. Topical low-dose estrogens are effective and also alleviate urinary incontinence and prevent recurrent urinary tract infections. Women should not be denied long-term use of topical estrogens as long as they feel that this treatment is of benefit to them, because the safety data are reassuring. Non-hormonal preparations (lubricants and moisturizers) should be the first-line treatment for VVA in women taking adjuvant endocrine therapies for cancers considered to be hormone-dependent. They can be used over the long term.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
StatePublished - Jun 2021


FundersFunder number
ITF Research Pharma
Proyecto Omega III
Sistema de Investigaci?n y Desarrollo
Sistema de Investigación y Desarrollo
Universidad Cat?lica de Santiago de Guayaquil
Universidad Católica de Santiago de Guayaquil554-56
Vice-Rectorado de Investigaci?n & Postgrado
Vice-Rectorado de Investigación & Postgrado


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