Vaginal Estrogen Utilization Among Medicare Beneficiaries With Genitourinary Syndrome of Menopause
Authors' conclusion
In this large cohort study, 9.0% of female Medicare beneficiaries with a diagnosis indicative of GSM filled a VE prescription. Younger and healthier beneficiaries and those with GSM multimorbidity were more likely to fill a VE prescription. The majority of patients with GSM symptoms, including dyspareunia, vulvovaginal atrophy, and recurrent urinary tract infections, did not fill a VE prescription. Improving patient and practitioner education, revising the diagnostic code schema to capture the full breadth of symptoms, and validating GSM clinical phenotypes will help facilitate care and enhance our understanding of symptoms in research studies.
Study context
- Population
- Women aged ≥66 years with a diagnosis indicative of genitourinary syndrome of menopause (GSM), Medicare Parts A, B and D, 2006–2018; breast and/or endometrial cancer within 6 months of GSM diagnosis excluded
- Participants
- 1,838,732 women
- Outcome
- Proportion of women with a VE prescription claim (cream, ring or tablet)
- Follow-up
- From first GSM diagnosis to end of Medicare enrollment or study period
Methodological detailspopulation-based, 20% random sample of Medicare fee-for-service beneficiaries, Data analysis October 2023 to June 2024
- Population-based
- 20% random sample of Medicare fee-for-service beneficiaries
- Data analysis October 2023 to June 2024
Main finding
As reported in the abstract
Women filling vaginal estrogen (VE) prescriptions
165 530
9.0%
Median (IQR) time to VE after diagnosis
15 (2-46) months
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Patient characteristics associated with VE claim>86 yearsvs 66-70 yearsMultivariable logistic regression | 0.59 (0.58–0.60) | |
| Patient characteristics associated with VE claimCharlson score ≥5vs Charlson score 0Multivariable logistic regression | 0.67 (0.66–0.69) | |
| Patient characteristics associated with VE claimRecurrent UTIsvs Local sexual symptomsLeast likely to have a VE claim · multivariable logistic regression | 0.54 (0.46–0.64) | |
| 0.512Adjusted odds ratio (log scale) |
Patient characteristics associated with VE claim
| aOR (95% CI) | ||
|---|---|---|
| Vulvovaginal symptomsMultivariable logistic regression | 2.70 (2.45–2.97) | |
| GSM multimorbidityMultivariable logistic regression | 15.91 (14.41–17.57) | |
| 0.050.21520Adjusted odds ratio (log scale) |
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →