Different Dosing Way Estrogen Replacement Therapy And Genitourinary Syndrome Of Menopause Correlation :A Meta-analysis

Objective:To evaluate the efficacy of different dosing way estrogen replacement therapy in women with genitourinary syndrome of menopause by the Meta-analysis,and then to provide treatment for the disease in clinical work.Method:Pub Med,Embase,Cochrane,Web of science,CNKI,CBM,Wanfang Data were comprehensively searched for relevant studies in English and Chinese which were published during 1985.01-2017.01.At the same time,we also searched the school library by manual retrieval methods.We selected the literature that met our inclusion and exclusion criteria which we designed before,and then we extracted relevant data.We made the meta analysis by the Rev Man5.3 software.Results:We included 16 researches,and all of them were published in English and belonged to randomized controlled trials.According to the different dosage of estrogen replacement therapy we grouped all the studies,and then analyzed respectively compared with the placebo treatment effect.Transvaginal gi ven estrogen replacement therapy compared with placebo,we found 3 studies mentioned the vaginal maturation index increased,so we got the results :MD=15.82,95%CI(2.22,29.41),Z=2.28,P=0.02<0.05,the difference between two groups had statistical significance.There were three studies concerned about the vaginal PH decrease,we analyzed the data,the results showed : MD=1.26,95%CI(1.10,1.43),Z=14.82,P<0.00001,the difference between two groups had statistical significance.We included 5 studies which mentioned the vaginal dryness improvement,we got the results: RR=2.74,95%CI(1.59,4.74),Z=3.61,P=0.0003,P<0.05,the difference between two groups had statistical significance.There were 3studies mentioned the stress urinary incontinence improvement efficacy,the results revealed : RR 3.93,95%CI(2.94,5.26),Z=9.20,P<0.00001,the difference between two groups had statistical significance.We included 5 studies which mentioned the improvement of dyspareunia,the results showed: RR 2.68,95%CI(1.67,4.29),Z=4.10,P<0.0001,the difference between two groups had statistical significance.Oral estrogen replacement therapy compared with placebo,there were 2 studies showed us the vaginal maturation index increased,the results indicated: MD 16.84,95%CI(15.22,18.47),Z=20.33,P<0.00001,the difference between two groups had statistical significance.We included 3 studies which mentioned vaginal PH decrease,the results pointed out: MD 0.33,95%CI(0.05,0.62),Z=2.27,P=0.02,the difference between two groups had statistical significance.But we analyzed the urinary syndrome data,we found no statistical significance between two groups.Transdermal estrogen therapy compared with placebo,we included 3 studies which showed us about vaginal PH decrease data,the result showed us :MD=0.77,95%CI(0.49,1.04),Z=5.41,P<0.00001,the difference between two groups had statistical significance.Conclusions:Transvaginal estrogen replacement therapy compared with placebo,the efficacy of GSM is remarkable.Oral estrogen replacement therapy in vaginal mature index increase and vaginal PH decrease effect is obvious,and percutaneous given estrogen replacement therapy in vaginal PH decrease effect is obvious too.But due to this research included the literature is relatively small,we still need more high quality,large sample researches for further analysis,provide evidence to support clinical work.