FIG. 1.

Serum estradiol levels (mean ± SD) in postmenopausal women before vaginal therapy administration or with placebo, or untreated used as a control (without or without VVA), or those from assay validation studies; only studies using MS-based assays were included. Baseline is in PMW with VVA in trials at baseline before vaginal estrogens^26-29 or DHEA^30,31; No VVA is untreated PMW without VVA in various clinical trials^31,32; VVA is untreated PMW with VVA from trials of vaginal DHEA³¹; Placebo is PMW given placebo in vaginal therapy trials^26,30; Assay is PMW whose E2 levels were measured in assay validation studies.^37-43 DHEA, dehydroepiandrosterone; E2, 17β-estradiol; MS, mass spectroscopy; PMW, postmenopausal women; VVA, vulvar and vaginal atrophy.