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Randomized trial of estradiol vaginal ring versus oral oxybutynin for the treatment of overactive bladder

Nelken, Rebecca S. MD1; Özel, Begüm Z. MD1; Leegant, Ava R. MD1; Felix, Juan C. MD1,2; Mishell, Daniel R. Jr MD1

doi: 10.1097/gme.0b013e3182104977
Original Articles

Objective: The aim of this study was to compare the efficacy of the ultralow-dose estradiol vaginal ring with that of oral oxybutynin in the treatment of overactive bladder in postmenopausal women.

Methods: Postmenopausal women with an overactive bladder were recruited from the general gynecology clinic. Participants were randomized to receive either the ultralow-dose estradiol vaginal ring or oral oxybutynin for 12 weeks. The primary outcome was a decrease in the number of voids in 24 hours. The secondary outcomes were quality-of-life questionnaires, vaginal pH levels, and vaginal maturation index.

Results: Fifty-nine women were enrolled. Thirty-one were randomized to receive oxybutynin, whereas 28 received the estradiol vaginal ring. Women who received oxybutynin had a mean decrease of 3.0 voids per day, and women who received the vaginal ring had a mean decrease of 4.5 voids per day, with no significant difference between the groups. There was a significant improvement in Urogenital Distress Inventory and Incontinence Impact Questionnaire scores in both groups, with no significant difference in improvement between the two groups.

Conclusions: Ultralow-dose estradiol-releasing vaginal ring and oral oxybutynin seem to be similarly effective in decreasing the number of daily voids in postmenopausal women with overactive bladder.

Oral oxybutynin chloride and estradiol-releasing vaginal ring are similarly effective in reducing daily micturition episodes and in improving quality of life in postmenopausal women with an overactive bladder.

From the Departments of 1Obstetrics and Gynecology and 2Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Received June 24, 2010; revised and accepted January 13, 2011.

Funding/support: This study was supported by an unrestricted grant from Pfizer Inc., New York, NY.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Rebecca S. Nelken, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 150 N Robertson Blvd, Suite 200, Beverly Hills, CA 90211. E-mail:

©2011The North American Menopause Society