ReviewsMeta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee☆
Section snippets
Materials and methods
The literature review included a search of the databases of Excerpta Medica, Biosis, and MEDLINE, as well as a hand search of the relevant journals published between January 1969 (the start date of MEDLINE) and April 1995. The search was limited to English-language articles.
To be considered for inclusion, articles had to be original publications in a peer-reviewed journal, the subjects had to have urogenital atrophy, and the outcome of therapy had to be reported by one or more of the following
Results
Seventy-seven articles were reviewed and 58 were used for the meta-analysis. Of the 19 articles not used in the analysis, six did not contain outcomes that were considered in the meta-analysis, 11 had data that were inadequate for analysis, and two could not be classified appropriately.
Ten placebo controlled trials from nine articles were used to address the first aim of whether estrogen had a significant effect on urogenital atrophy. Table 2 describes the placebo controlled trials. From the
Discussion
Although this meta-analysis has clearly shown that estrogen therapy is beneficial for the treatment of symptoms and signs of urogenital atrophy, it is difficult to draw conclusions. The studies reviewed were heterogeneous and lacked standardization of patient selection, diagnostic criteria, study design, therapeutic intervention, follow up and, particularly, outcome variables. In addition, bias toward publication of positive results as well as variability in execution and implementation of
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The authors thank Pharmacia and Upjohn for providing financial support for this study.