Urogenital atrophy: advantages of local administration of estrogens

Urogenital aging is a multisystemic process, involving all the components of genital tissues, leading to microscopic and macroscopic anatomic changes. Functional consequences of urogenital aging affect vaginal ecosystems, sexual and bladder function, the tonus and competence of the levator ani, the anatomic relationships of genital organs, predisposing/precipitating genital (uterine/vaginal) prolapse. Genital aging becomes relevant after the menopause, for the precipitating effect of estrogen loss. Estrogens are the etiological answer to vaginal aging: however concern about systemic absorption prevents many physician from prescription.