Estrogen therapy in the management of problems associated with urogenital ageing: a simple diagnostic test and the effect of the route of hormone administration.

Estrogen deficient women are prone to problems such as vaginal dryness, dyspareunia and a predilection to recurrent urinary tract infections and urinary incontinence. A preliminary double-blinded study in 67 symptomatic postmenopausal women confirmed: (1) that atrophic vaginitis is associated with an increase in the lateral wall vaginal pH; (2) this is paralleled by similar changes in pH in the urethra; (3) locally applied vaginal conjugated estrogen cream normalizes the pH in the vagina and urethra. Thus, the testing of the vaginal pH serves both as a surrogate for evaluating urethral pH and as a monitor of compliance with treatment.