title: 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.
  
  
  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-mum estradiol vaginal tablet or 1g 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+/-1.20mm) or in the control group (3.90+/-1.40 and 3.70+/-1.50mm). 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. rajmo@mahidol.ac.th
authors.forename: Jittima
authors.initials: J
authors.lastname: Manonai
authors.forename: Apichart
authors.initials: A
authors.lastname: Chittacharoen
authors.forename: Urusa
authors.initials: U
authors.lastname: Theppisai
mesh_terms: D000282:Administration, Intravaginal; D000368:Aged; D001158:Arteries / Q000502:physiology; D004717:Endometrium / Q000098:blood supply / Q000000981:diagnostic imaging; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D017698:Postmenopause; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects
chemical_list: D004967:Estrogens