Trial reportThe Journal of clinical endocrinology and metabolism2014
Effects of preoperative local estrogen in postmenopausal women with prolapse: a randomized trial.
Trial report in The Journal of clinical endocrinology and metabolism, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Preoperative Locally Applied Oestrogen in Postmenopausal Women With Pelvic Organ Prolapse: Changes in Subjective and Objective Outcome - a Prospective, Randomized, Double-blind, Placebo-controlled, Multicenter Study
Topical Estrogen: Brief Intervention to Improve Postoperative Experience for Transgender Men Undergoing Hysterectomy
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Endometrial safety of low-dose vaginal estrogens in menopausal women: a systematic evidence review.Menopause (New York, N.Y.) · 2019Pooled it
- Vaginal estrogen use in postmenopausal women with pelvic floor disorders: systematic review and practice guidelines.International urogynecology journal · 2015Guideline
- Preoperative promestriene for hysteroscopy: a randomized clinical trial.Revista da Associacao Medica Brasileira (1992) · 2024Trial
- Effects of preoperative intravaginal estrogen on pelvic floor disorder symptoms in postmenopausal women with pelvic organ prolapse.American journal of obstetrics and gynecology · 2023Trial
- Trial
- Does preoperative locally applied estrogen treatment facilitate prolapse-associated symptoms in postmenopausal women with symptomatic pelvic organ prolapse? A randomised controlled double-masked, placebo-controlled, multicentre study.BJOG : an international journal of obstetrics and gynaecology · 2021Trial
- Review
- Multidimensional regulation of estrogen signaling in pelvic floor connective tissue homeostasis and remodeling.Frontiers in immunology · 2026Review
- Single-cell and spatial multi-omics reveal estrogen-mediated vaginal wall microenvironment remodeling and a perivascular reparative niche in postmenopausal pelvic organ prolapse.Frontiers in immunology · 2026Article
- Involuntary Urine Loss in Menopause-A Narrative Review.Journal of clinical medicine · 2025Review
- Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study.Obstetrics & gynecology science · 2025Article
- Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study.Asian journal of urology · 2024Article
- Practical Guidance on the Use of Vaginal Laser Therapy: Focus on Genitourinary Syndrome and Other Symptoms.International journal of women's health · 2024Review
- Care after premenopausal risk-reducing salpingo-oophorectomy in high-risk women: Scoping review and international consensus recommendations.BJOG : an international journal of obstetrics and gynaecology · 2023Article
- Perioperative Factors Affecting the Healing of Rectovaginal Fistula.Journal of clinical medicine · 2023Review
- New Possibilities for Hormonal Vaginal Treatment in Menopausal Women.Journal of clinical medicine · 2023Review
- Oestrogen therapy for treating pelvic organ prolapse in postmenopausal women.The Cochrane database of systematic reviews · 2023Review
- Molecular Landscape of Pelvic Organ Prolapse Provides Insights into Disease Etiology.International journal of molecular sciences · 2023Article
- Potential molecular targets for intervention in pelvic organ prolapse.Frontiers in medicine · 2023Review
- Local Estrogen Therapy for Pelvic Organ Prolapse in Postmenopausal Women: A Systematic Review and Meta-Analysis.Iranian journal of public health · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
contextPelvic organ prolapse (POP) increases in prevalence with age; recurrence after surgical repair is common.
objectiveThe objective of the study was to determine the effects of local estrogen treatment on connective tissue synthesis and breakdown in the vaginal wall of postmenopausal women planning surgical repair of POP.
designThis was a randomized trial.
settingThe study was conducted at an academic tertiary medical center. PATIENTS OR OTHER
participantsPostmenopausal women with a uterus and symptomatic anterior and/or apical prolapse at stage 2 or greater participated in the study.
interventionEstrogen (Premarin) or placebo cream for 6 weeks preoperatively was the intervention.
main outcome measuresFull-thickness anterior apical vaginal wall biopsies were obtained at the time of hysterectomy and analyzed for mucosa and muscularis thickness, connective tissue synthesis, and degradation. Serum levels of estrone and 17β-estradiol were analyzed at baseline and the day of surgery using highly sensitive liquid chromatography-tandem mass spectrometry.
resultsFifteen women per group (n = 30 total) were randomized; 13 per group underwent surgery. Among drug-adherent participants (n = 8 estrogen, n = 13 placebo), epithelial and muscularis thickness was increased 1.8- and 2.7-fold (P = .002 and P =.088, respectively) by estrogen. Collagen types 1α1 and 1α2 mRNA increased 6.0- and 1.8-fold in the vaginal muscularis (P < .05 for both); collagen type Ia protein increased 9-fold in the muscularis (P = .012), whereas collagen III was not changed significantly. MMP-12 (human macrophage elastase) mRNA was suppressed in the vaginal mucosa from estrogen-treated participants (P = .011), and matrix metalloprotease-9 activity was decreased 6-fold in the mucosa and 4-fold in the muscularis (P = .02). Consistent with menopausal norms, serum estrone and 17β-estradiol were low and did not differ among the two groups.
conclusionsVaginal estrogen application for 6 weeks preoperatively increased synthesis of mature collagen, decreased degradative enzyme activity, and increased thickness of the vaginal wall, suggesting this intervention improves both the substrate for suture placement at the time of surgical repair and maintenance of connective tissue integrity of the pelvic floor.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.