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Ekene Enemchukwu, MD, on trends in vaginal estrogen use for GSM
"What we found is that 9% of women with a GSM-related diagnosis filled a prescription for vaginal estrogen during the study period, and these women tended to be younger," says Ekene Enemchukwu, MD, MPH, FACS, URPS.
Vaginal estrogen may be underutilized among female Medicare beneficiaries with genitourinary syndrome of menopause (GSM)-related conditions, according to findings from a recent study.
In an interview with Urology Times®, Ekene Enemchukwu, MD, MPH, FACS, URPS shared key findings from the study, “Advancing Women’s Health: Addressing Gaps in Genitourinary Syndrome of Menopause,” which was presented at the Society of Urodynamics, Female Pelvic Medicine, & Urogenital Reconstruction 2025 Winter Meeting in Rancho Mirage, California. Overall, data showed that of the 1.9 million patients with a GSM-related condition, only 9.1% filled a prescription for vaginal estrogen during the study period.
Enemchukwu is an associate professor of urology, and by courtesy, of obstetrics and gynecology (urogynecology), at Stanford Medicine in Palo Alto, California.
Data from the study also found that of the prescriptions that were filled, 40% were prescribed by OB/GYNs, 31% are prescribed by primary care providers, and only 8% were prescribed by urologists.
According to Enemchukwu, “That's not surprising. We are a small piece of the pie when we think about providers who manage this condition.”
Further, the median time from GSM diagnosis to prescription claim was 15 months. Patients who had multiple symptoms groups were more likely to have a prescription claim. Specifically, “women with vulvovaginal, urethral and bladder symptoms were 3.4 times (95% CI 3.34-3.45) more likely to fill a VE prescription than women with vulvovaginal symptoms alone,” the authors wrote.
The authors also found that “younger age (66-70 years), lower Charlson comorbidity index, white race and Northeast or West region were independently associated with a higher odds of [a vaginal estrogen] claim.”
REFERENCE
1. Crane E, Gallo K, Gunamany S, Burton C, Zhang CA, Enemchukwu E. Advancing women’s health: Addressing gaps in genitourinary syndrome of menopause. Presented at: Society of Urodynamics, Female Pelvic Medicine, & Urogenital Reconstruction 2025 Winter Meeting. Rancho Mirage, California. February 26-March 1, 2025. Abstract 29. https://sufuorg.com/docs/meetings/sufu2502/program-book-full.aspx
