ClinicalTrials.gg
CompletedNCT02869165Updated May 18, 2021

Vaginal and Urinary Microbiome Trial

A Phase 4 interventional study of Conjugated equine estrogen topical cream and Apricot kernel oil in Atrophic Vaginitis, Menopause and Recurrent Urinary Tract Infections, sponsored by University of Louisville. Completed at 1 site in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-05-18.

Sponsored by University of Louisville · Phase 4, Interventional, and Basic science

From the registry’s dates

  • Primary completion was Jun 2018, 8 years 4 months ago, and no results have been posted to the registry.
Phase
Phase 4
Study type
Interventional
Enrollment
110
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 23 studies in Atrophic Vaginitis with a site in United States — 2 open to participants now, 2 under way, none of them phase 3. Atrophic Vaginitis · United States.

Enrollment
11th of 23
110 · median 69
Started
2017
the only one that year
Phase 4
5 of 23
1 open now
Registered
16th of 23
by date

Among the 23 studies in Atrophic Vaginitis with a site in United States, this one is the 11th largest by enrollment, is the only one that started in 2017, is one of 5 in phase 4, and was the 16th registered.

By phase

23 studies; the count open now beside each. This study's row is marked.

Phase 311 · 0 open
Phase 4this study5 · 1 open
No phase4 · 1 open
Phase 12 · 0 open
Phase 1/21 · 0 open

By the year they started

First in 2005; this study’s year is marked. 1 started in 2017.

Size and results

Median enrollment 69 across the 23 interventional studies. Of the 21 that completed or were terminated, 12 (57%) have results posted.

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Watch this landscapeDownload CSVWith an account: a weekly mail of what changed among 23 studies in Atrophic Vaginitis with a site in United States, or all of them as a file.
02

Study summary

A randomized controlled trial looking at the effects of vaginal estrogen and a nonhormonal alternative on the vaginal and urinary microbiome in women with genitourinary syndrome of menopause.

Read the detailed description

This is a study is looking at the effects of vaginal estrogen and a nonhormonal alternative on the vaginal and urinary microbiome in women with genitourinary syndrome of menopause. The primary objective is to describe the bacterial communities associated in the vagina and urine of postmenopausal women receiving treatment for genitourinary syndrome of menopause with conjugated equine estrogen topical cream (Premarin®) and a nonhormonal alternative (apricot kernel oil). The participants will be randomized to either conjugated equine estrogen topical vaginal cream or apricot kernel oil. They will be given validated questionnaires to assess their urinary and vaginal symptoms, sexual function, quality of life, and impressions of severity and improvement.

03

Conditions studied

  • Atrophic Vaginitis
  • Menopause
  • Recurrent Urinary Tract Infections

Keywords

  • Postmenopausal
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 18-years old
  • Women who qualify for vaginal estrogen
  • Suitability for follow-up
  • Hormonally status: Bilateral past ovarian removal, ≥1 year since last menses if uterus in place, OR hysterectomized woman with ≥1 ovary in place AND >1 year of menopausal symptoms or laboratory confirmation of menopausal hormonal status (such as serum follicle stimulation hormone >25 IU/mL)
  • GSM symptoms (including, but not limited to genital symptoms of dryness, burning, itching, and irritation; sexual symptoms of lack of lubrication, discomfort or pain, and impaired sexual function; and urinary symptoms of urgency, frequency, dysuria and recurrent (UTIs)

Exclusion criteria

Exclusion Criteria:

  • Age \< 18-years old
  • Known allergic reaction or other adverse reactions to Premarin® or any of its components or apricot kernel oil
  • Nut allergy
  • Inability to use or place vaginal therapy due to altered mental status or anatomical reasons
  • Already using vaginal estrogen or apricot kernel oil in the past two weeks
  • Known active vaginal infection (symptomatic and/or untreated) or completion of treatment for bacterial vaginosis or cervical/vaginal infection within one week of recruitment
  • History of recurrent or chronic bacterial vaginosis with > 2 episodes per year or symptoms reported for > 6 months out of the last year.
  • History of active vaginal ulcerative disease (active ulcers from atrophy, herpes symptoms at recruitment or herpes with >2 outbreaks per year or last outbreak \<1month ago, or vaginal laceration.
  • Chronic antibiotic or probiotic use for indications not listed.
  • Pelvic organ prolapse beyond the hymenal ring
  • Using a vaginal pessary or indwelling urinary catheter
  • Evidence of active urinary tract infection by history and symptoms, urine dipstick, or urine culture on day of presentation or within last 2 weeks (defined as ≥ 100,000 colonies same pathologic bacteria on clean catch or 10,000 colonies on straight catheter specimen)
  • Recurrent urinary tract infection 3 episodes with the last year or 2 episodes within the last 6 months.
  • History of venous or arterial thromboembolism or genetic predisposition to thromboembolism.
  • Ovarian cancer and estrogen responsive cancer including endometrial or breast or breast cancer history of unknown hormonal status
  • Vaginal mesh erosion, sutures visible in the vagina or granulation tissue
  • Uncorrected vesicovaginal or rectovaginal fistula
  • Severe fecal or anal incontinence
  • Active vulvar dermatoses (lichen sclerosis, Behcet's disease, vulvar eczema) and on chronic topical .
  • Subjects with absolute to estrogen, such as diabetes mellitus with end-organ damage and vascular disease, impaired liver function or a hepatic hemangioma, chronic renal disease, migraine with aura, systemic lupus erythematosus with prior thrombosis or vascular damage or other end-organ damage
  • Patients \< 6 weeks postop
  • Inability to speak or read English
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 4
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
110 participants (actual)

Study arms

  • Experimental
    Conjugated equine estrogen topical cream

    The conjugated equine estrogen topical vaginal cream 0.5 grams per vagina two times per week at nights for 3 months.

    Drug: Conjugated equine estrogen topical cream

  • Experimental
    Apricot kernel oil

    One teaspoonful per vagina every night for 3 months.

    Drug: Apricot kernel oil

Interventions

  • Comparison of the bacterial communities in the vagina and urine of postmenopausal women who use Premarin vaginal cream versus apricot kernel oil and to themselves before and after use.

    Also known as: Premarin vaginal cream, Vaginal estrogen cream, CEE topical cream

  • DrugApricot kernel oil

    Comparison of the bacterial communities in the vagina and urine of postmenopausal women who use Premarin vaginal cream versus apricot kernel oil and to themselves before and after use.

    Also known as: Natural oil, Organic oil

06

What researchers measure

Primary outcomes

  1. Vaginal and urinary predominance of anaerobic/fastidious taxonomy of micro-organisms on genomic, microbial DNA analysis of vaginal and urinary specimens.

    Predominance (greater than 50%) in vaginal and urinary specimen of anaerobic and/or fastidious organisms in the study population compared between conjugated equine estrogen cream (Premarin) and apricot kernel oil. The primary analysis will compare the prevalence of genomic taxonomic anaerobic and/or fastidious organism predominance (\>50%) between the estrogen group and the non-estrogen alternative group.

    Time frame: 3 months

Secondary outcomes

  1. Change in vaginal symptom questionnaire (VSQ)

    Change in vaginal symptoms as assessed by vulvovaginal symptom questionnaire (VSQ) at baseline and after treatment.

    Time frame: 3 months

  2. Vaginal and urinary predominance of anaerobic/fastidious taxonomy of micro-organisms on genomic, microbial DNA analysis of vaginal and urinary specimens.

    Predominance (greater than 50%) in vaginal and urinary specimen of anaerobic and/or fastidious organisms in the study population compared between the conjugated equine estrogen cream (Premarin) and apricot kernel oil. The primary analysis will compare the prevalence of genomic taxonomic anaerobic and/or fastidious organism predominance (\>50%) between the baseline patients and the patients at 3 months and compare the change in prevalence in this taxonomic predominance between the two study groups.

    Time frame: 3 months

07

Study locations

1 site
  • Health Care Outpatient Center and Springs Medical Center
    Louisville, Kentucky 40202 and 40205, United States
08

References and documents

Publications

  • Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013 Sep;20(9):888-902; quiz 903-4. doi: 10.1097/GME.0b013e3182a122c2. PubMed 23985562 ↗
  • Parish SJ, Nappi RE, Krychman ML, Kellogg-Spadt S, Simon JA, Goldstein JA, Kingsberg SA. Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. Int J Womens Health. 2013 Jul 29;5:437-47. doi: 10.2147/IJWH.S44579. Print 2013. PubMed 23935388 ↗
  • Danforth KN, Townsend MK, Lifford K, Curhan GC, Resnick NM, Grodstein F. Risk factors for urinary incontinence among middle-aged women. Am J Obstet Gynecol. 2006 Feb;194(2):339-45. doi: 10.1016/j.ajog.2005.07.051. PubMed 16458626 ↗
  • Nachtigall LE. Comparative study: Replens versus local estrogen in menopausal women. Fertil Steril. 1994 Jan;61(1):178-80. doi: 10.1016/s0015-0282(16)56474-7. PubMed 8293835 ↗
  • Siddiqui H, Nederbragt AJ, Lagesen K, Jeansson SL, Jakobsen KS. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol. 2011 Nov 2;11:244. doi: 10.1186/1471-2180-11-244. PubMed 22047020 ↗
  • Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001500. doi: 10.1002/14651858.CD001500.pub2. PubMed 17054136 ↗
  • Lamont RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T, Kusanovic JP, Romero R. The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG. 2011 Apr;118(5):533-49. doi: 10.1111/j.1471-0528.2010.02840.x. Epub 2011 Jan 20. PubMed 21251190 ↗
  • Hummelen R, Macklaim JM, Bisanz JE, Hammond JA, McMillan A, Vongsa R, Koenig D, Gloor GB, Reid G. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness. PLoS One. 2011;6(11):e26602. doi: 10.1371/journal.pone.0026602. Epub 2011 Nov 2. PubMed 22073175 ↗
  • Martin DH. The microbiota of the vagina and its influence on women's health and disease. Am J Med Sci. 2012 Jan;343(1):2-9. doi: 10.1097/MAJ.0b013e31823ea228. PubMed 22143133 ↗
  • Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas. 1996 Apr;23(3):259-63. doi: 10.1016/0378-5122(95)00955-8. PubMed 8794418 ↗
  • Coyne KS, Margolis MK, Thompson C, Kopp Z. Psychometric equivalence of the OAB-q in Danish, German, Polish, Swedish, and Turkish. Value Health. 2008 Dec;11(7):1096-101. doi: 10.1111/j.1524-4733.2008.00346.x. Epub 2008 May 16. PubMed 18489500 ↗
  • Rogers RG, Rockwood TH, Constantine ML, Thakar R, Kammerer-Doak DN, Pauls RN, Parekh M, Ridgeway B, Jha S, Pitkin J, Reid F, Sutherland SE, Lukacz ES, Domoney C, Sand P, Davila GW, Espuna Pons ME. A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Int Urogynecol J. 2013 Jul;24(7):1091-103. doi: 10.1007/s00192-012-2020-8. Epub 2013 Apr 30. PubMed 23632798 ↗
  • Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer. 2001 Jan;37(2):189-97. doi: 10.1016/s0959-8049(00)00353-1. PubMed 11166145 ↗
  • Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006 May;194(5):1455-61. doi: 10.1016/j.ajog.2006.01.060. PubMed 16647928 ↗
  • Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003. PubMed 8628042 ↗
  • Yalcin I, Bump RC. Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol. 2003 Jul;189(1):98-101. doi: 10.1067/mob.2003.379. PubMed 12861145 ↗
  • Freedman M, Kaunitz AM, Reape KZ, Hait H, Shu H. Twice-weekly synthetic conjugated estrogens vaginal cream for the treatment of vaginal atrophy. Menopause. 2009 Jul-Aug;16(4):735-41. doi: 10.1097/gme.0b013e318199e734. PubMed 19252451 ↗
  • Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause. 2008 Jul-Aug;15(4 Pt 1):661-6. doi: 10.1097/gme.0b013e31815a5168. PubMed 18698279 ↗
  • Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, Olivera CK, Abed H, Balk EM, Murphy M; Society of Gynecologic Surgeons Systematic Review Group. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014 Dec;124(6):1147-1156. doi: 10.1097/AOG.0000000000000526. PubMed 25415166 ↗
  • Rahn DD, Ward RM, Sanses TV, Carberry C, Mamik MM, Meriwether KV, Olivera CK, Abed H, Balk EM, Murphy M; Society of Gynecologic Surgeons Systematic Review Group. Vaginal estrogen use in postmenopausal women with pelvic floor disorders: systematic review and practice guidelines. Int Urogynecol J. 2015 Jan;26(1):3-13. doi: 10.1007/s00192-014-2554-z. Epub 2014 Nov 13. PubMed 25392183 ↗
  • Erekson EA, Yip SO, Wedderburn TS, Martin DK, Li FY, Choi JN, Kenton KS, Fried TR. The Vulvovaginal Symptoms Questionnaire: a questionnaire for measuring vulvovaginal symptoms in postmenopausal women. Menopause. 2013 Sep;20(9):973-9. doi: 10.1097/GME.0b013e318282600b. PubMed 23481118 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jan 2017 to primary completion in Jun 2018, 17 months.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 31, 2016
First posted
Aug 16, 2016
StartActual
Jan 2017
Primary completionActual
Jun 30, 2018
CompletionActual
Dec 31, 2019
Last update
May 18, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 18, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02869165
Responsible party
Deslyn T. Hobson (Fellow Female Pelvic Medicine and Reconstructive Surgery, University of Louisville) — Principal investigator
First posted
Aug 16, 2016
Start date
Jan 2017
Primary completion
Jun 30, 2018
Completion
Dec 31, 2019
Last update
May 18, 2021

Study contacts

Deslyn Hobson, M.D.
principal investigator · University of Louisville School of Medicine

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2021. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Estrogens

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