Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study

Moral, Eloy; Delgado, Juan Luis; Carmona, Francisco; Caballero, Borja; Guillán, Cristina; González, Paula Minguell; Suárez-Almarza, Javier; Velasco-Ortega, Syra; Nieto, Concepción

doi:10.1080/13697137.2017.1421921

Cited by 103 publications

(123 citation statements)

References 35 publications

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“…The diagnosis of GSM may prove to be challenging as the clinical manifestations of GSM are mild and nonspecific in approximately 50% of postmenopausal women [2]. An observational study by Moral et al found that vaginal dryness is the most prevalent and bothersome symptom as it affects up to 93% of women; the study also noted that this symptom is characterized as being moderate to severe in intensity in 68% of the cases [3]. Irritation and burning/itching of vulva/vagina are other symptoms that women with GSM frequently complain about, and they are reported in 63.3% of the affected women.…”

Section: Review Clinical Manifestations and Evaluationmentioning

confidence: 99%

“…Loss of libido and arousal and per vagina bleeding or spotting during or after intercourse are also frequently reported. Urinary symptoms are considered less frequent with dysuria (29%), urgency and urge incontinence (28%), recurrent urinary tract infections, stress incontinence, and voiding issues being some of the most common manifestations [3,6]. Moreover, other common signs of GSM include decreased moisture (94%), loss of vaginal rugae (78%), vaginal pallor (75%), and decreased elasticity (68%).…”

Section: Review Clinical Manifestations and Evaluationmentioning

confidence: 99%

“…The prevalence and severity of the above-mentioned symptoms vary in relation to time passed since menopause, with most of them being more frequent and intense five years after menopause when compared with women closer to premenopausal status (GSM symptoms occur in 84% of women six years after menopause versus one year postmenopausally in 65%) [3,8]. Contrary to the vasomotor symptoms related to menopause, which tend to be milder over time, symptoms of GSM appear to have a greater impact on the quality of life (QOL) of the affected women.…”

Section: Signs and Symptoms Of Gsmmentioning

confidence: 99%

“…This is due to the fact that they rarely resolve spontaneously and, in most cases, deteriorate if left untreated, thereby negatively affecting patients' confidence and intimacy with their partners [9,10]. The impact in the QOL has been shown to be more profound in sexually active women [3].…”

Section: Signs and Symptoms Of Gsmmentioning

confidence: 99%

“…GSM-like symptoms may also be present in 15% of premenopausal women due to the hypoestrogenic state [2]. Nonetheless, the vast majority of women suffering from GSM are of older age, with 50-70% of postmenopausal women being symptomatic at least to some degree [3]. To this day, GSM remains extremely underdiagnosed despite its high prevalence, mostly because of the reluctance among women to seek help due to embarrassment, or as a result of a tendency among many women to consider it as a normal feature of natural aging.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Genitourinary Syndrome of Menopause: An Overview of the Recent Data

Angelou

Grigoriadis

Diakosavvas

et al. 2020

Cureus

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Section: Review Clinical Manifestations and Evaluationmentioning

confidence: 99%

Section: Review Clinical Manifestations and Evaluationmentioning

confidence: 99%

Section: Signs and Symptoms Of Gsmmentioning

confidence: 99%

Section: Signs and Symptoms Of Gsmmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Genitourinary Syndrome of Menopause: An Overview of the Recent Data

Angelou

Grigoriadis

Diakosavvas

et al. 2020

Cureus

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Effect of Fractional Carbon Dioxide vs Sham Laser on Sexual Function in Survivors of Breast Cancer Receiving Aromatase Inhibitors for Genitourinary Syndrome of Menopause

et al. 2023

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ImportanceSurvivors of breast cancer present more severe symptoms of genitourinary syndrome of menopause (GSM) than patients without history of breast cancer. Recently, new treatments, such as vaginal laser therapy, have appeared, but evidence of their efficacy remains scarce.ObjectiveTo assess the safety and efficacy of carbon dioxide (CO2) vs sham vaginal laser therapy after 6 months of follow-up in survivors of breast cancer with GSM receiving aromatase inhibitors.Design, Setting, and ParticipantsThis prospective double-blind sham-controlled randomized clinical trial with two parallel study groups was performed during October 2020 to March 2022 in a tertiary referral hospital. Survivors of breast cancer using aromatase inhibitors were assessed for eligibility, and eligible patients were randomized into the 2 treatment groups. Follow-up was conducted at 6 months. Data were analyzed in July 2022.InterventionsAll patients from both groups were instructed to use the first-line treatment (FLT) based on nonhormonal moisturizers and vaginal vibrator stimulation. Patients for each group were allocated to 5 monthly sessions of fractional CO2 laser therapy (CLT) or sham laser therapy (SLT).Main Outcomes and MeasuresThe primary outcome was sexual function, evaluated through Female Sexual Function Index (FSFI) score. Other subjective measures of efficacy included a visual analog scale of dyspareunia, vaginal pH, a Vaginal Health Index, quality of life (assessed via Short-Form 12), and body image (assessed with the Spanish Body Image Scale). Objective measures of efficacy included vaginal maturation index, vaginal epithelial elasticity (measured in Pascals) and vaginal epithelial thickness (measured in millimeters). Measures were assessed before and after the intervention. Tolerance (measured on a Likert scale), adverse effects, and estradiol levels were recorded.ResultsAmong 211 survivors of breast cancer assessed, 84 women were deemed eligible and 72 women (mean [SD] age, 52.6 [8.3] years) were randomized to CLT (35 participants) or SLT (37 participants) and analyzed. There were no statistically significant differences between groups at baseline. At 6 months, both groups showed improvement in FSFI (mean [SD] score at baseline vs 6 months: CLT, 14.8 [8.8] points vs 20.0 [9.5] points; SLT, 15.6 [7.0] points vs 23.5 [6.5] points), but there was no significant difference between CLT and SLT groups in the improvement of sexual function evaluated through the FSFI test overall (mean [SD] difference, 5.2 [1.5] points vs 7.9 [1.2] points; P = .15) or after excluding women who were not sexually active (mean [SD] difference, 2.9 [1.4] points vs 5.5 [1.1] points; P = .15). There were also no differences between improvement of the 2 groups at 6 months of follow-up in the other assessed subjective outcomes, including dyspareunia (mean [SD] difference, −4.3 [3.4] vs −4.5 [2.3]; P = .73), Vaginal Health Index (mean [SD] difference, 3.3 [4.1] vs 5.0 [4.5]; P = .17), body image (mean [SD] difference, −3.7 [4.5] vs −2.7 [4.8]; P = .35), and quality of life (mean [SD] difference, −0.3 [3.6] vs −0.7 [3.2]; P = .39). Similarly, there were no differences in improvements in objective outcomes, including vaginal pH (mean [SD] difference, −0.6 [0.9] vs −0.8 [1.2]; P = .29), vaginal maturation index (mean [SD] difference, 10.2 [17.4] vs 14.4 [17.1]; P = .15), vaginal epithelial thickness (mean [SD] difference, 0.021 [0.014] mm vs 0.013 [0.012] mm; P = .30), vaginal epithelial elasticity (mean [SD] difference, −1373 [3197] Pascals vs −2103 [3771] Pascals; P = .64). There were significant improvements in the overall analysis regardless of group in many outcomes. The 2 interventions were well tolerated, but tolerance was significantly lower in the CLT group than the SLT group (mean [SD] Likert scale score, 3.3 [1.3] vs 4.1 [1.0]; P = .007). No differences were observed in complications or serum estradiol levels.Conclusions and RelevanceIn this randomized clinical trial, vaginal laser treatment was found to be safe after 6 months of follow-up, but no statistically significant differences in efficacy were observed between CLT and SLT.Trial RegistrationClinicalTrials.gov identifier: NCT04619485

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Development and validation of the genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM‐SVTAQ): An electronic patient‐reported outcomes measure

Hassanein,

Huri,

Baig

et al. 2023

Intl J Gynecology & Obste

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ObjectivesTo develop and validate an electronic, patient‐reported outcomes measure (PROM) specific for genitourinary syndrome of menopause (GSM) patients. The PROM aimed to accurately assess the burden of GSM symptoms, their impact on health‐related and sexual quality of life, and the acceptability of vaginal treatments.MethodsThe study encompassed a comprehensive three‐stage approach to the development and validation of the PROM. Initially, during the preliminary design stage, the necessity for a new PROM was recognized, an expert panel was formed, and semi‐structured qualitative interviews were carried out with GSM patients. In the second stage, the study used the five‐step pre‐validation methodology established by Prior et al. to generate and refine the PROM items. The third and final stage encompassed the determination of scale and item content validity indexes to ensure validity. Additionally, the reliability of each construct was evaluated using Cronbach's α.ResultsThe resulting PROM was named GSM‐SVTAQ (GSM‐symptoms and vaginal treatments acceptability questionnaire). It demonstrated excellent validity in assessing symptoms burden, health‐related and sexual quality of life, and vaginal treatment acceptability, with high content validity indices and strong internal consistency. The scale content validity indices and Cronbach's α coefficients for the three domains were (0.926, 0.939), (0.875, 0.947), and (0.824, 0.855), respectively.ConclusionThe GSM‐SVTAQ stands as the first GSM‐specific, valid, and reliable PROM capable of comprehensively measuring the three components of GSM and the acceptability of vaginal treatments. Its implementation has the potential to significantly enhance patient care and outcomes in GSM management.

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Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study

Cited by 103 publications

References 35 publications

The Genitourinary Syndrome of Menopause: An Overview of the Recent Data

The Genitourinary Syndrome of Menopause: An Overview of the Recent Data

Effect of Fractional Carbon Dioxide vs Sham Laser on Sexual Function in Survivors of Breast Cancer Receiving Aromatase Inhibitors for Genitourinary Syndrome of Menopause

Development and validation of the genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM‐SVTAQ): An electronic patient‐reported outcomes measure

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