Consensus statement – Urogenital atrophy

Abstract

This guidance refers to urogenital atrophy, a chronic and progressive condition due to estrogen deficiency, most commonly associated with the menopause. There is a potential negative impact on all urogenital tissue quality including the vulva, vagina, bladder and urethra. Symptoms may not become apparent for several years after the menopause and therefore any association is lost, with women accepting symptoms as a normal part of the aging process. There may be reluctance to discuss symptoms with a clinician and this is likely to be linked with under diagnosis and under treatment. Urogenital atrophy has been described as a silent epidemic with lack of awareness affecting an accurate diagnosis and access to treatment. Whilst vaginal estrogen (also referred to as local estrogen) therapy is the best-known treatment, newer drugs and interventions are now available.

Estradiol and Estrogen-like Alternative Therapies in Use: The Importance of the Selective and Non-Classical Actions

“…Additionally, E2 plays a pivotal role in the regulation of hyaluronic acid, mucopolysaccharides, and sebum production as well [337][338][339]. Due to these alterations, E2 deficiency may result in changes in the moisture content and hydration of the skin as well as of all urogenital tissue including the vulva, vagina, bladder, and urethra vaginal mucosa [340]. One of the most serious consequences is the urogenital atrophy (newly renamed as GSM, see Section 5.1), which may contribute to sexual dysfunction [183].…”