Vaginal administration of sex steroids in menopausal hormone therapy

Martha Hickey

Topical and other non-oral approaches are an alternative to oral medications to manage systemic menopausal symptoms including vasomotor symptoms (hot flushes and/or night sweats) and local symptoms such as vaginal dryness. Systemic absorption from the vaginal epithelium makes vaginal administration a possible delivery route for systemic hormone therapies. This presentation will discuss current evidence for the efficacy and safety of vaginally administered sex steroids including micronized progesterone, indicating how this evidence can be translated into clinical practice.

Learning outcomes for this presentation include understanding the efficacy and safety of vaginal steroid treatments for menopausal symptoms.


Martha Hickey is Professor of Obstetrics and Gynaecology and Head of the Gynaecology Research Centre at the University of Melbourne and the Royal Women’s Hospital, Victoria, Australia. She is also an NHMRC Practitioner Fellow. In her clinical practice she runs the largest public menopause service in Australia and in 2002 established the first multidisciplinary service for managing menopausal symptoms after cancer (MSAC). This service has now been replicated across Australia. She is a Senior Editor for the Cochrane Collaboration Gynaecology and Infertility Group and leads the international COMMA (Core Outcomes in Menopause) initiative.