Experience with ospemifene in patients with vulvar and vaginal atrophy and urinary incontinence: case studies

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Abstract

Pelvic floor muscle atrophy and collagen loss in connective tissue due to declining estrogen production in women as they age may underlie the increasing prevalence of urge and stress incontinence. Estrogen therapy can correct the deficiency of estrogen receptors in genitourinary structures after menopause, but estrogen is not suitable for all women. A series of retrospective studies showed that urinary symptoms improved in women with overactive bladder syndrome who were receiving ospemifene for vulvovaginal atrophy (VVA), a component of genitourinary syndrome of menopause. Two case studies presented in this article support the findings. The woman in case 1 was 76 years old, had a 4-year history of urinary incontinence (UI), and several risk factors for urinary symptoms. During 15 months’ treatment with ospemifene for VVA, her urinary symptoms also improved as evidenced by a reduction (from four/day to one/day) in sanitary pad requirements to manage leakage. The patient in case 2 had predominantly moderate-to-severe VVA and mild mixed UI. During 6 months’ treatment with ospemifene, she experienced marked improvement in VVA symptoms, including normalization of vaginal pH and disappearance of dyspareunia, accompanied by a decrease in urinary symptoms, which allowed her to resume a normal exercise program.

Keywords: ospemifene, urinary tract symptoms, vulvar and vaginal atrophy.

Citation: Estrada Blanco Z, Lilue M, Palacios S. Experience with ospemifene in patients with vulvar and vaginal atrophy and urinary incontinence: case studies. Drugs in Context 2020; 9: 2020-3-6. DOI: 10.7573/dic.2020-3-6

Contributions: All authors contributed equally to the preparation of this case report. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Dr. Estrada Blanco reports personal fees from Shionogi, outside the submitted work. Dr. Lilue reports personal fees from Shionogi, outside the submitted work. Dr. Palacios reports grants from Pfizer, grants from Amgen, grants from Gedeon Ritcher, grants from Exeltis, grants from Bayer, grants from MSD, grants from Procare Health, grants and personal fees from Shionogi, grants from Serelys, and personal fees from Mylan, outside the submitted work. The authors have also provided scientific support to Shionogi Spain by lecturing and/or taking part in Advisory Board meetings organized by Shionogi (Madrid, Spain). The authors’ time was compensated by Shionogi Spain according to local codes of practice. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/05/dic.2020-3-6-COI.pdf

Acknowledgements: Medical writing assistance was provided by Jon Monk and Kerry Dechant on behalf of Content Ed Net (Madrid, Spain). This article forms part of a Special Issue. All authors contributed to developing this Special Issue by sharing their experience with the benefit of patients in mind. The publication is expected to benefit gynecologists in their daily clinical practice by increasing knowledge and expertise.

Funding declaration: Medical writing assistance was funded by Shionogi (Madrid, Spain). This article forms part of a Special Issue funded by Shionogi (Madrid, Spain).

Copyright: Copyright © 2020 Estrada Blanco Z, Lilue M, Palacios S. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Estrada Blanco Z, Lilue M, Palacios S. https://doi.org/10.7573/dic.2020-3-6. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/experience-with-ospemifene-in-patients-with-vulvar-and-vaginal-atrophy-and-urinary-incontinence:-case-studies/

Correspondence: Zuramis Estrada Blanco, Obstetrics and Gynecology Service, University Hospital of Southeast of Madrid, & CIMEG (Centro internacional de Investigación, Médico estético, uro-Ginecológico), 28500 Madrid, Spain. zuryestradablanco@gmail.com

Provenance: submitted; externally peer reviewed.

Submitted: 20 March 2020; Peer review comments to author: 16 April 2020; Revised manuscript received: 20 May 2020; Accepted: 21 May 2020; Publication date: 1 July 2020.

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