Comparison 1. Oestrogen ring versus placebo or other regimens.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Improvement in symptoms (participant‐assessed at end point)	6		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
1.1 Oestrogen ring versus oestrogen cream	2	341	Odds Ratio (M‐H, Fixed, 95% CI)	1.33 [0.80, 2.19]
1.2 Oestrogen ring versus oestrogen tablets	3	567	Odds Ratio (M‐H, Fixed, 95% CI)	0.78 [0.53, 1.15]
1.3 Oestrogen ring versus placebo	1	67	Odds Ratio (M‐H, Fixed, 95% CI)	12.67 [3.23, 49.66]
2 Endometrial thickness	2		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
2.1 Oestrogen ring versus oestrogen cream	2	273	Odds Ratio (M‐H, Fixed, 95% CI)	0.36 [0.14, 0.94]
3 Improvement in symptoms (clinician‐assessed at end point)	6		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
3.1 Oestrogen ring versus oestrogen cream	3	533	Odds Ratio (M‐H, Fixed, 95% CI)	1.04 [0.70, 1.53]
3.2 Oestrogen ring versus oestrogen tablets	2	397	Odds Ratio (M‐H, Fixed, 95% CI)	1.45 [0.90, 2.32]
3.3 Oestrogen ring versus placebo	1	49	Odds Ratio (M‐H, Fixed, 95% CI)	2.0 [0.55, 7.31]
4 Improvement in symptoms (decrease in vaginal pH at end point)	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
4.1 Oestrogen ring versus oestrogen cream	1	165	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.19, 0.39]
4.2 Oestrogen ring versus oestrogen tablets	1	146	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐0.38, ‐0.02]
4.3 Oestrogen ring versus placebo	1	37	Mean Difference (IV, Fixed, 95% CI)	‐1.31 [‐1.82, ‐0.80]
5 Improvement in symptoms (increase in maturation indices at end point)	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
5.1 Oestrogen ring versus oestrogen cream	2	341	Mean Difference (IV, Fixed, 95% CI)	0.79 [‐1.52, 3.09]
5.2 Oestrogen ring (7.5 ug) versus placebo	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Oestrogen ring (100 ug) versus placebo	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.4 Oestrogen ring (50 ug) versus placebo	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.5 Oestrogen ring (unspecified dose) versus placebo	1	37	Mean Difference (IV, Fixed, 95% CI)	24.4 [15.25, 33.55]
6 Adverse events (breast disorders)	4		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
6.1 Oestrogen ring versus oestrogen cream	1	192	Odds Ratio (M‐H, Fixed, 95% CI)	0.12 [0.01, 1.13]
6.2 Oestrogen ring versus oestrogen tablets	3	587	Odds Ratio (M‐H, Fixed, 95% CI)	0.42 [0.12, 1.52]
7 Adverse events (total adverse events)	2		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
7.1 Oestrogen ring versus oestrogen cream	1	192	Odds Ratio (M‐H, Fixed, 95% CI)	0.88 [0.47, 1.63]
7.2 Oestrogen ring versus placebo	1	37	Odds Ratio (M‐H, Fixed, 95% CI)	0.45 [0.11, 1.78]
8 Adherence to treatment	3		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
8.1 Oestrogen ring versus oestrogen cream	2	350	Odds Ratio (M‐H, Fixed, 95% CI)	2.23 [1.31, 3.80]
8.2 Oestrogen ring versus oestrogen tablets	1	146	Odds Ratio (M‐H, Fixed, 95% CI)	1.69 [0.66, 4.31]