{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T08:14:04Z","timestamp":1771316044249,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","award":["R016532025"],"award-info":[{"award-number":["R016532025"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness of two dosages (12.5 and 25\u2009\u03bcg) of 17\u03b2\u2010estradiol vaginal gel for treating postmenopausal vaginal atrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized non\u2010inferiority trial was conducted in the Gynecologic Endocrinology and Menopause Clinic of a university hospital from June 2022 to February 2023. A total of 80 postmenopausal women were randomly assigned to receive a 12.5\u2009\u03bcg (half\u2010dose) or 25\u2009\u03bcg (full\u2010dose) 17\u03b2\u2010estradiol vaginal gel daily for 14\u2009days, followed by twice\u2010weekly for 10\u2009weeks. Efficacy outcomes were vaginal maturation value (VMV), vaginal health index (VHI), vaginal pH, most bothersome symptoms (MBSs), and female sexual function index (FSFI). Safety outcomes were endometrial thickness, serum estradiol level, and adverse events. All study outcomes were evaluated at three time points: baseline, week 4, and week 12.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At week 12, both the half\u2010dose and full\u2010dose groups displayed a significant improvement in the VMV, with median (25th\u201375th percentile) of 67.3 (59.1\u201372.9) and 71.8 (60.3\u201379.5), respectively. While the full\u2010dose group exhibited slightly greater improvement in VMV, the difference was not statistically significant. The upper bound of the 95% confidence interval (CI) for the median difference in VMV was below the predefined non\u2010inferiority margin of 15 (4.5, 95% CI: \u22120.5, 10.0;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.082). Additionally, both groups demonstrated significant improvements from baseline in all efficacy outcomes without any safety concerns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both 12.5 and 25\u2009\u03bcg doses of 17\u03b2\u2010estradiol vaginal gel are safe and effectively improve vaginal atrophy in postmenopausal women. The non\u2010inferiority of the half\u2010dose to the full\u2010dose suggests its potential as a cost\u2010effective treatment option with comparable benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70403","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T08:48:39Z","timestamp":1753174119000},"page":"363-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effectiveness of 12.5 and 25 micrograms 17\u03b2\u2010estradiol vaginal gel for postmenopausal vaginal atrophy: A randomized non\u2010inferiority trial"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7860-3181","authenticated-orcid":false,"given":"Panicha","family":"Chantrapanichkul","sequence":"first","affiliation":[{"name":"Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital Mahidol University  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