Diagnosis and Treatment of Genitourinary Syndrome of Menopause

Hodges, Ashley; Holland, Aimee Chism; Dehn, Barbara; Pace, Diane Todd

doi:10.1016/j.nwh.2018.07.005

Cited by 11 publications

(7 citation statements)

References 26 publications

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“…8 The exact number of affected women is thus unknown, with speculative estimates ranging from 10–84% of menopausal women. 3,4,24–55 Improving diagnostic accuracy has the potential to improve precision in relation to prevalence rates and to support a more accurate estimate of the burden of the disease.…”

Section: Methodsmentioning

confidence: 99%

Urogenital atrophy: The ‘unknown factors’ challenging current practice

Briggs

Hapangama

2021

Post Reprod Health

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Urogenital atrophy occurs as a result of the effect of estrogen deficiency on the tissue quality in the vulva, vagina, urethra and bladder. It is a common consequence of the menopause, with possibly up to 80% of women experiencing symptoms. Despite a number of different diagnostic methods, there is no validated objective method by which to confirm the diagnosis in clinical practice and research settings. Education, for women and clinicians, is called for to support diagnosis and treatment. However, before this can be of global benefit, development of an accessible and reproducible diagnostic test is required. Current assessment methods include routine history and clinical examination, with the clinician’s opinion based on their subjective observations. A vaginal smear to assess the ratio of superficial to parabasal cells and measurement of the pH of the vaginal secretions is more commonly used in research settings. A number of formulae have been postulated to facilitate the diagnosis including the Vaginal Health Index, the Vulval Health Index, the Genitourinary Syndrome of the Menopause assessment tool, the Genital Health Clinical Evaluation and vaginal biopsy and assessment of the vaginal microbiome. However, none of these potential methods of assessment has been validated. This article focuses on what we do not know about urogenital atrophy including the prevalence, the most appropriate terminology, aetiology, pathogenesis and the most objective and reproducible method of assessment.

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Section: Methodsmentioning

confidence: 99%

Urogenital atrophy: The ‘unknown factors’ challenging current practice

Briggs

Hapangama

2021

Post Reprod Health

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“…This relieves dryness and efficacy has been demonstrated to match that of local vaginal estrogen therapy. 7 To minimise any adverse effect on the vaginal microbiome, the pH and osmolality of lubricants and moisturisers should be similar to that of naturally occurring vaginal secretions. 8 Lubricants and moisturisers are particularly relevant in women for whom estrogen is contraindicated.…”

Section: Non-hormonal Lubricants and Moisturisersmentioning

confidence: 99%

Consensus statement – Urogenital atrophy

Briggs

2022

Post Reprod Health

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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.

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“…In fact, various cohort studies reported a 27% to 55% prevalence of GSM in postmenopausal women and estimated that such symptoms persist in 10% to 25% of women even after receiving hormonal therapy [17, 18]. More recent studies show a prevalence of GSM ranging from 50% to 84% [19-21], and it may be even higher because symptoms of GSM may also involve premenopausal women with a hypoestrogenic state, such as women with premature ovarian failure, hypothalamic amenorrhoea, surgical menopause, and those who were treated with systemic chemotherapy or pelvic irradiation [22, 23]. The risk factors of GSM include cigarette smoking and alcohol abuse, which are correlated with a reduction in oestrogen levels and an absence of vaginal childbirth [24].…”

Section: Genitourinary Syndrome Of Menopausementioning

confidence: 99%

Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function

Rosa

Ciebiera

Lin

et al. 2019

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Climacteric is considered a natural phase in a woman's aging process and is defined as the period starting from the decline in ovarian activity until the end of ovarian function. Natural menopause is defined as the permanent cessation of menstrual periods, after 12 months of amenorrhoea without any other pathological or physiological cause. It is characterised by a decrease in ovarian function with a consequent reduction in oestrogen levels. This condition, which involves

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Diagnosis and Treatment of Genitourinary Syndrome of Menopause

Cited by 11 publications

References 26 publications

Urogenital atrophy: The ‘unknown factors’ challenging current practice

Urogenital atrophy: The ‘unknown factors’ challenging current practice

Consensus statement – Urogenital atrophy

Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function

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