title: Women's preferences toward attributes of local estrogen therapy for the treatment of vaginal atrophy.
abstract: OBJECTIVE
  Decreased estrogen production due to menopause is often associated with vaginal atrophy, and estrogen therapy is the most effective treatment for the management of this condition. This study investigated women's preferences relating to various aspects of local estrogen therapy (LET) for the treatment of postmenopausal vaginal atrophy.
  
  
  METHODS
  The study involved 423 women aged >50 years who were resident in Sweden, had experienced menopausal changes in and around the vagina, and had used LET for these changes. The women completed an online questionnaire.
  
  
  METHODS
  The questionnaire involved a discrete choice experiment to determine women's willingness to pay for different characteristics of therapy. Time of LET appliance, use of disposable applicators with small tablets compared with both dosing syringes with vaginal cream and vagitories, and therapy that did/did not cause smudges/leakage were all considered.
  
  
  RESULTS
  The women had no significant preference as to the time of day LET should be used. However, quantifying other preferences suggested that respondents were willing to pay € 66.58 or € 60.32 per month extra for using disposable applicators with small tablets rather than dosing syringes with vaginal cream or vagitories, respectively, and to avoid smudges/leakage.
  
  
  CONCLUSIONS
  This survey suggests that women may prefer using disposable applicators with small tablets to deliver LET and value therapy that does not cause smudges/leakage. It is possible that if women are able to use their preferred form of LET, improved uptake or adherence of such medication may enhance the management of postmenopausal vaginal atrophy.
authors: Department of Obstetrics and Gynecology, Sahlgren's Academy, University of Göteborg, 416 85 Göteborg, Sweden. Electronic address: lars-ake.mattsson@vgregion.se.
authors: Lars-Åke
authors: LÅ
authors: Mattsson
authors: Novo Nordisk Scandinavia AB, Box 505 87, 202 15 Malmö, Sweden. Electronic address: asae@novonordisk.com.
authors: Åsa
authors: Å
authors: Ericsson
authors: Incentive Partners, Holte Stationsvej 14, 2840 Holte, Denmark. Electronic address: mb@i-p.dk.
authors: Mette
authors: M
authors: Bøgelund
authors: Novo Nordisk Inc., 100 College Road West, Princeton, NJ 08540, United States. Electronic address: riom@novonordisk.com.
authors: Ricardo
authors: R
authors: Maamari
mesh_terms: D000368:Aged; D001284:Atrophy; D001294:Attitude to Health; D004209:Disposable Equipment; D004337:Drug Carriers; D004414:Dyspareunia / Q000188:drug therapy; D015914:Estrogen Replacement Therapy / Q000295:instrumentation / Q000379:methods*; D004967:Estrogens / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D057240:Patient Preference; D017698:Postmenopause; D011795:Surveys and Questionnaires; D013594:Syringes; D013607:Tablets; D014621:Vagina / Q000187:drug effects* / Q000473:pathology; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage / Q000627:therapeutic use; D014623:Vaginal Diseases / Q000188:drug therapy
chemical_list: D004337:Drug Carriers; D004967:Estrogens; D013607:Tablets; D014622:Vaginal Creams, Foams, and Jellies
keywords: Local estrogen therapy; Menopause; Preference; Survey; Vaginal atrophy; Willingness to pay