Objective:To investigate the efficacy and safety of promestriene vaginal gelatin capsules administered through different schemes in the treatment of postmenopausal female urethral syndrome.Methods:A total of 120 patients with postmenopausal female urethral syndrome who received treatment in General Hospital of Medical and Health Group of Cixi Third People's Hospital from January 2021 to June 2022 were included in this study. They were randomly divided into groups A and B ( n = 60/group). Group A was treated with vaginal gelatin capsules containing 10 mg promestriene once a day. Group B was treated with vaginal gelatin capsules containing 10 mg promestriene twice a day. Both groups were treated for 20 days as a course of treatment. The improvement of symptoms, lower urinary tract symptom score, quality of life score, estradiol level, follicle stimulating hormone level, and endometrial thickness were compared between the two groups. Results:After treatment, the scores of incomplete urination, urination interval, intermittent urination, dysuria, thinner urine line, urination force, and nocturnal urination times in group A were (2.51 ± 1.76) points, (2.66 ± 1.08) points, (2.61 ± 1.45) points, (2.48 ± 1.42) points, (2.85 ± 1.03) points, (2.48 ± 1.42) points, and (2.52 ± 1.72) points, respectively, which were significantly lower than (3.15 ± 1.35) points, (3.23 ± 1.14) points, (2.99 ± 1.57) points, (3.08 ± 1.09) points, (3.45 ± 1.72) points, (3.25 ± 1.08) points, and (3.21 ± 1.87) points, respectively, in group B ( t = 10.57, 9.78, 13.83, 10.34, 9.35, 12.34, 9.45, all P < 0.05). The quality of life score in group A was (2.45 ± 0.86) points, which was significantly lower than (3.51 ± 0.92) points in group B ( t = 5.45, P < 0.05). There were no significant differences in estradiol and follicle stimulating hormone levels and endometrial thickness between the two groups before and after treatment (all P > 0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion:Local application of promestriene vaginal gelatin capsules can improve the urethral syndrome in postmenopausal women. The once daily 10 mg promestriene vaginal gelatin capsule administration scheme can achieve better efficacy and safety than the twice daily administration scheme. The study is innovative, scientific, and worthy of clinical promotion.