Hormonal replacement therapy has a prominent role in the treatment of pelvic floor dysfunction. The preferred route of administration is local with vaginal creams, rings, or tablets. This low-dose route of administration is not associated with any significant systemic absorption, thus minimizing any concerns regarding potential vascular, cardiac, or breast consequences of systemic hormonal replacement therapy. We routinely prescribe low-dose local estrogen therapy for our postmenopausal urogynecologic patients, combined with patient education materials in order to optimize compliance with therapy.

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