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Promestriene
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Promestriene is a 3-propyl and 17β-methyl ether of estradiol that may be used intravaginally to relieve vaginal atrophy and its associated symptoms such as dryness and itching. Promestriene has also been used in trials studying the prevention of hypospadias (1).
Management of postmenopausal vulvovaginal atrophy: recommendations of the International Society for the Study of Vulvovaginal Disease
Published in Gynecological Endocrinology, 2021
Faustino R. Pérez-López, Nancy Phillips, Pedro Vieira-Baptista, Bina Cohen-Sacher, Susana C. A. V. Fialho, Colleen K. Stockdale
Vaginal estrogens are effective for the management of VVA. Several formulations are available: creams, pessaries, tablets and releasing rings. Available options include promestriene, estradiol, conjugated estrogens, and estriol [8]. The absorption is variable, depending on the degree of VVA, but plasma estrogen levels do not exceed normal postmenopausal range (≤20 pg/mL) [7–9]. Topical vaginal estrogens are started with nightly application for 2–3 weeks and tapered to 2–3 times per week. However, application must be tailored to each woman. Creams and gels are popular, providing dosing flexibility. The estrogen releasing vaginal ring has action for 3 months, improving adherence. In some women with vaginal prolapse, retention of the ring may be difficult. Promestriene (estradiol 3-propyl 17β-methyl diether), a synthetic estrogen which is used vaginally in a 1% cream formulation, seems to have only intramucosal effects and has been tested in women with gynecological cancer [10,11]. Despite promising results, larger and longer series regarding long-term safety are lacking.
Efficacy of low-dose vaginal 17β-estradiol versus vaginal promestriene for vulvovaginal atrophy
Published in Climacteric, 2022
S. Palacios, M. Ramirez, M. Lilue
The main objective of the current study was to investigate and compare the acceptability of low-dose vaginal 17β-estradiol (estradiol) tablets and vaginal promestriene cream in women with moderate-to-severe symptomatic vulvovaginal atrophy. Choice of study treatments was based on potential differences in adherence. Although both treatments are administered by the vaginal route, they have different pharmaceutical forms and, as a result, adherence may not be the same [13,14]. Another factor that can affect adherence is systemic absorption, which is reflected by changes in circulating hormones such as estrone sulfate (E1S). In clinical studies, even low-dose estradiol increased E1S [15], while promestriene did not [16].
Different local estrogen therapies for a tailored approach to GSM
Published in Climacteric, 2023
R. E. Nappi, L. Tiranini, E. Martini, D. Bosoni, C. Cassani, L. Cucinella
Promestriene is a synthetic estrogen widely used as cream or insert at 10 mg dose [36]. Being minimally absorbed, it has a superficial activity on the vaginal mucosa and is considered a safer option in women with severe atrophy [38] and in estrogen-sensitive cancer patients displaying good efficacy on urogenital signs and symptoms [39].