Transvaginal color Doppler sonographic assessment of uterus and ovaries in postmenopausal women: The effect of local estrogen treatment

Abstract

Objective The objective was to evaluate the effect of local estrogen treatment on the uterus and ovaries using transvaginal color Doppler sonography. Materials and methods A 12-week randomized open-label study of postmenopausal women taking local estrogen treatment and controls was conducted. The study group was treated with either a 25-μm estradiol vaginal tablet or 1 g of conjugated estrogen cream intravaginally each day for 2 weeks followed by twice a week for 10 weeks. The control group did not receive any type of hormone replacement therapy. All women underwent transvaginal ultrasonography and color Doppler imaging of the uterine arteries both before starting local estrogen treatment and after treatment. The uterine volume, ovarian volume, endometrial thickness, and uterine arterial blood flow of the two groups were evaluated. Statistical analysis was performed using paired and unpaired Student's t-test. A p value of <0.05 was considered statistically significant. Results Of the 53 postmenopausal women recruited to this study, 26 women received local estrogen treatment for treatment of urogenital symptoms and 27 untreated women constituted the control group. The mean age was 54.85 ± 5.51 years. The uterine and ovarian volumes were not significantly different before and after treatment in either of the groups. The endometrial thickness did not change in the local estrogen treatment group (4.00 ± 1.60 and 4.30 ± 1.20 mm) or in the control group (3.90 ± 1.40 and 3.70 ± 1.50 mm). The mean resistance indices in the local estrogen treatment group before and after treatment (1.01 ± 0.10 and 0.96 ± 0.10) were not significantly different from those of the control group (0.96 ± 0.15 and 0.97 ± 0.10). The mean pulsatility index after 12 weeks of treatment was lower than before treatment, although not statistically significantly (3.69 ± 1.32 and 4.27 ± 1.49; p > 0.05), and the mean pulsatility indices did not differ between the study and the control groups. Conclusion The volumes of the uterus and the ovaries, including endometrial thickness, were not affected and did not show any significant influence of the 12-week local estrogen treatment. The uterine arterial blood flow did not significantly change after treatment.