No abstract

Genitourinary syndrome of menopause (GSM) is a set of symptoms of atrophy, the main cause of which are evolutive changes in the vulvovaginal and urethral regions. GSM is a common condition affecting up to 90 % of menopausal women. The main symptoms encountered in this syndrome include: dryness of the vulvovaginal area (more than 90 %), dyspareunia (78 %), itching (57 %) and burning (57 %). These symptoms, according to various questionnaires, strongly affect the quality of women’s life, as well as their sexual life. A review of GSM therapy with plasma therapy (PRP) and injection with hyaluronic acid was performed. The clinical observation and the process of managing patients with manifestations of GSM are described in detail. An analysis of the effectiveness and safety of injection techniques in GSM is considered.

Lichen planus (LP) is a T-cell-mediated inflammatory dermatosis with an unclear etiology that affects the skin, nails and mucous membranes. The article outlines modern ideas about lichen planus, affecting the vulva. The issues of etiopathogenesis, clinical picture, differential diagnosis of various forms of this dermatosis are considered. The histopathological picture of vulvar LPL is described in detail. Possible complications, including anatomical abnormalities of the vulvar architectonics and the risk of malignant transformation, are considered. Various methods of treatment for this disease, local treatment regimens are presented, an overview of systemic drugs is given, as well as alternative approaches to patient management.

Lichen sclerosus (LS) is a chronic inflammatory disease that is 6-10 times more common in women than in men. The drug affects between 1 in 1000 and 1 in 300 people in the general population, but the exact prevalence is unknown due to the fact that the disease is often asymptomatic. The article presents modern ideas about lichen sclerosus. Issues of various etiological theories of origin and pathogenesis are considered. The description of the clinical picture of lichen sclerosus is given. Diagnostic approaches are described, including the histological picture. Possible complications, including anatomical abnormalities of the vulvar architectonics and the risk of malignant transformation, are discussed in detail. Various methods of treatment and care for this disease, local treatment schemes are presented, an overview of systemic drugs and surgical operations, as well as further observation and management of patients is given.

Involutional changes in the vulvovaginal area involve a series of transformations leading to vulvovaginal atrophy (VVA) during menopause. Signs and symptoms most often observed in this syndrome: vaginal dryness (54.4100%), dyspareunia (17.677.6%), burning (2.056.9%), itching (7.856.6%) and dysuria (5.936.1%). Other complaints include deformity of the vulva, irritation, and recurrent bacterial infections of the urinary tract or vagina, and yeast infection. Vaginal dryness, dyspareunia and irritation are the symptoms that most affect a woman's quality of life. The article analyzes modern ideas about the genitourinary syndrome of menopause. The questions of the mechanisms of occurrence are considered, a description of the clinical picture is given. The issues of treatment of atrophy of the vulvovaginal region are discussed in detail, in particular, special attention is paid to physiotherapeutic methods of treatment.