{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:18:24Z","timestamp":1778285904752,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Local estrogen therapy (LET) has many benefits, but little is known regarding adherence and reasons for discontinuation. We aimed to evaluate fill\/continuation rates of LET and assess factors associated with not filling\/discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Prospective observational study of adult women newly prescribed LET. Participants completed Pelvic Floor Distress Inventory 20 (PFDI-20) and the Day-to-Day Impact of Vaginal Aging (DIVA) at baseline, 3-, 6-, and 12-months from initial prescription. Participants who discontinued LET were queried regarding reason for discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 155 participants were included. Mean age was 65 (+\/\u221210) and 57% had private insurance. The most common indications for prescription with LET were atrophic vaginitis 61 (39%) and recurrent urinary tract infection 34 (22%). At baseline, 94% filled initial prescription. Continuation rates were 78%, 90%, and 79% at 3-, 6-, and 12-months, respectively, but 93 (60%) were lost to follow-up over the study period. Common reasons for not starting LET included cost (33%) and concern for side effects (22%). Common reasons for discontinuing were mess of using therapy (19%) and concern for side effects (16%). PFDI-20 and DIVA domain scores except self-concept decreased across all timepoints for all participants with no difference between women who continued versus discontinued LET. Univariate analysis did not find any factors associated with LET discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>LET use is associated with improved pelvic floor and vaginal symptoms up to 12 months following initiation. Prospective evaluation was challenging due to high loss to follow-up. A total of 26% discontinued LET over 1 year. Barriers to initiation and discontinuation such as cost, mess, and concern for side effects are potentially modifiable factors that physicians can address to improve adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996251363800","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T14:18:15Z","timestamp":1759846695000},"page":"1240-1246","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Local Estrogen Adherence: A Prospective Pilot Study"],"prefix":"10.1177","volume":"34","author":[{"given":"Feven W.","family":"Getaneh","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon F.","family":"Pennycuff","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University Hospital, Durham, North Carolina, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haley","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kolm","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Gutman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.Cd001405"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0000000000000921"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/spv.0000000000000244"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000000526"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3000-1"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05133-5"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2007.0407"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0000000000000729"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.08.019"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.025"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0000000000000281"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0000000000000465"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/ijwh.S41897"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/ijwh.S57900"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001500.pub3"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/ijgm.S43192"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000574"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15409996251363800","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996251363800","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996251363800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:28:48Z","timestamp":1777706928000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/15409996251363800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/15409996251363800"],"URL":"https:\/\/doi.org\/10.1177\/15409996251363800","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}