Document Detail

Complication of a 2-mg estradiol vaginal ring: fibrotic vaginal adhesion.
MedLine Citation:
PMID:  24937026     Owner:  NLM     Status:  Publisher    
OBJECTIVE: This work aims to review a novel case of a retained 2-mg estradiol vaginal ring used to treat postmenopausal urogenital atrophy. The ring was found adhered to the posterior fornix by a fibrotic band. This is the first reported case in the medical literature.
METHODS: We describe the case of a postmenopausal woman experiencing symptoms of urogenital atrophy. Factors predisposing her to this complication (such as inconsistent use of other forms of vaginal estradiol, initial incorrect use of the ring with two rings in place, and subsequent vaginal stenosis and irritation requiring vaginal dilator therapy at one point in her treatment course) were analyzed. A review of the medical literature was performed to examine the safety profile of estradiol vaginal rings used to treat urogenital atrophy and to investigate the incidence of complications.
RESULTS: Two-milligram estradiol vaginal rings treat symptoms of urogenital atrophy by delivering a constant supply of estradiol to the vaginal epithelium. The ring has been shown to be as safe and effective as other forms of vaginal estrogen. Vaginal irritation is a known complication of 2-mg estradiol vaginal rings and other vaginal implants; however, none of the randomized controlled trials that have compared the ring to other vaginal estrogen forms have reported adherence of the ring to the vaginal epithelium.
CONCLUSIONS: Providers should be aware of the possibility of ring adherence to the vaginal epithelium and should exercise caution in using the 2-mg estradiol vaginal ring in women with significant vaginal stenosis or irritation.
Meghan E Pratts; Wen Shen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-16
Journal Detail:
Title:  Menopause (New York, N.Y.)     Volume:  -     ISSN:  1530-0374     ISO Abbreviation:  Menopause     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433353     Medline TA:  Menopause     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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