Genitourinary Syndrome of Menopause

Abstract

Genitourinary syndrome of menopause (GSM) occurs in approximately 50% of menopausal women but is both underrecognized and undertreated despite numerous treatment options. Vaginal dryness, irritation, dyspareunia, urinary frequency, and urinary urgency are some of the more common symptoms that can have a negative effect on women's lives and relationships. Treatment options can include over-the-counter moisturizers and lubricants that can be composed of water or silicone or have an oil base. However, women and health care providers need be aware of the effects of excipients in these products so that the therapy does not cause vaginal irritation. US Food and Drug Administration (FDA)-approved treatment options include vaginally administered estrogen products as well as dehydroepiandrosterone (prasterone) and the selective estrogen receptor modulator ospemifene. The prescription options have proven efficacy and safety and can be considered for use by women with a history of cancer following collaboration with the oncologist. Despite the FDA warning that recommends vaginal lasers not be used for vaginal rejuvenation, vaginal lasers have also been used as a treatment for GSM, but studies on their safety are limited. This article reviews GSM, including its impact, diagnosis, and treatment.

Effect of time‐restricted eating on sex hormone levels in premenopausal and postmenopausal females

“…However, among postmenopausal females, adrenal DHEA becomes one of the major precursors of estrogens and androgens. A decrease in DHEA among postmenopausal woman can induce sexual dysfunction [24], diminished skin tone [25], and vaginal dryness [26]. Although DHEA values decreased in the present study, they were still within the normal range for both premenopausal females (1.12–7.43 ng/mL) and postmenopausal females (0.6–5.7 ng/mL) [27].…”

Preliminary Cost Variance Modeling to Compare Autologous Intraovarian Platelet-Rich Plasma vs. Standard Hormone Replacement Therapy for Menopause Management

“…There is a nascent but enlarging body of OPRP literature investigating these topics. Genitourinary irritation, vaginal atrophy or dryness, and/or dyspareunia have a deeply personal and negative effect on women's health and relationships, impacting at least half of all menopausal women (Marino, 2021). When these symptoms were queried after OPRP, slightly more than half (41/80) noted improved vaginal lubrication/cervical mucus production with treatment (Sills et al, 2019).…”

Effect of ospemifene on vaginal microbiome in postmenopausal women with vulvovaginal atrophy

“…Several over-the-counter and government-approved prescription therapies demonstrate effectiveness, depending on the severity of symptoms. These include vaginal lubricants and moisturizers, vaginal estrogens and dehydroepiandrosterone, systemic hormone therapy (HT), and ospemifene (OSP), a selective estrogen receptor modulator 1,5 …”

“…These include vaginal lubricants and moisturizers, vaginal estrogens and dehydroepiandrosterone, systemic hormone therapy (HT), and ospemifene (OSP), a selective estrogen receptor modulator. 1,5 Previous studies have investigated the composition of the vaginal microbiome in women with VVA, seeking to unveil the relationship between bacterial genera, VVA symptoms, and severity. Compared with women with no VVA, the vaginal microbiota of women with mild or moderate atrophy is usually characterized by a marked reduction of lactobacilli, the hallmark of vaginal health/eubiosis, with the increase of other opportunistic bacteria, such as Gardnerella, Streptococcus, and Prevotella.…”