Quality of life and sexual function of naturally postmenopausal women on an ultralow-concentration estriol vaginal gel

Caruso, Salvatore; Cianci, Stefano; Amore, Francesca Flavia; Ventura, Betty; Bambili, Elisa; Spadola, Saveria; Cianci, Antonio

doi:10.1097/gme.0000000000000485

Cited by 56 publications

(23 citation statements)

References 33 publications

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“…Various therapeutic strategies, hormonal or not, oral or local, have been proposed for improving the vaginal microflora of postmenopausal women. Hormonal therapy (oral or local) has been associated with a healthy vaginal microbiota that is achieved by repopulating the Lactobacillus species back to a premenopausal status and by reducing the pH of vaginal fluid ( 11 - 13 ). Additionally, the use of vaginal estrogens reduced the incidence of urinary infections in postmenopausal women ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

Sarmento¹,

Fernandes²,

Marconi³

et al. 2020

Clinics

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We aimed to evaluate the effectiveness of microablative fractional radiofrequency (MAFRF) in the non-hormonal treatment of genitourinary syndrome of menopause. METHODS: We examined the cases of 55 postmenopausal women before and after treatment with regard to their vaginal health index (VHI), vaginal microbiota, vaginal pH, and cell maturation. Three applications of MAFRF were performed in the vagina/vaginal introitus. During the treatment, six vaginal smears were obtained and stained with the Papanicolaou stain for determining the degree of cell maturation and with Gram stain for classification of vaginal flora, as per the criteria of Spiegel and Amsel. For vaginal pH determination, pH indicator strips were applied against the vaginal wall. Statistical analysis was performed using SPSS for Windows (version 17.0). Data were reported as mean±standard deviation. The differences were analyzed using the statistical method of generalized estimation equations with autoregressive correlation structure ''1'' and robust standard errors. RESULTS: The mean age was 59.8±4.2 years, and the mean time of menopause was 15.4±4.5 years. After treatment, there was an increase in the percentage of Lactobacillus spp. (po0.001). Consequently, there was a progressive decrease in vaginal pH during the treatment (po0.001). Regarding cell maturation, there was a decrease in the percentage of parabasal cells (p=0.001) and an increase in the rate of superficial cells (po0.001). Additionally, there was an improvement in the VHI index. The mean VHI values before and after treatment were 13.2 ± 5.6 and 22.5 ± 3.7, respectively (po0.001). CONCLUSION: MAFRF treatment is well tolerated and leads to improvement in the vaginal microenvironment.

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Section: Discussionmentioning

confidence: 99%

Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

Sarmento¹,

Fernandes²,

Marconi³

et al. 2020

Clinics

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“…There were several studies demonstrated beneficial effects of estrogens, specifically designed to be administered vaginally, on female sexual function and quality of life [42,43]. This study was designed to be a pioneer of using oral medication, off-labelly administered vaginally to treat FSD.…”

Section: Discussionmentioning

confidence: 99%

Effects of vaginal administration of conjugated estrogens tablet on sexual function in postmenopausal women with sexual dysfunction: a double-blind, randomized, placebo-controlled trial

et al. 2020

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Background: Female sexual dysfunction (FSD) is prevalent in women with genitourinary syndrome of menopause (GSM). Vaginal estrogen is effective GSM treatment. This study was primarily aimed to evaluate the effects of vaginal administration of conjugated estrogens tablet on postmenopausal FSD using the Female Sexual Function Index (FSFI). Secondary aims were to evaluate vaginal pH, Vaginal Maturation Value (VMV), Normal Flora Index (NFI) and Most Bothersome Symptoms (MBS) changes. Methods: A double-blind trial was conducted in postmenopausal women with FSD (FSFI ≤26.55). Sixty-seven participants were randomized into two arms; vaginally administered conjugated estrogens tablet (0.625 mg, daily for 3 weeks then twice weekly for 9 weeks, n = 33), or placebo (n = 34). Results: There was no significant improvement of FSFI observed in estrogens arm compared to placebo in each domain and overall index (p = 0.182). The estrogens significantly improved vaginal pH and VMV, toward more acidity (p = < 0.001), higher VMV (p = < 0.001) and more superficial cells (p = < 0.001). We observed no significant difference in NFI and MBS between arms (p = 0.282, 0.182). Conclusion: We found no significant changes in FSFI, NFI, and MBS, but significant improvement in vaginal pH and VMV in postmenopausal women with FSD treated with vaginally administered conjugated estrogens tablet. Few side-effects were reported.

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“…Brand names include Ovestin ® and Gynest ® . A low-dose estriol vaginal gel formulation (0.005% estriol vaginal gel) has been shown to significantly increase vaginal maturation index and improve vaginal pH compared with a baseline evaluation in postmenopausal women [70]. A combination of low-dose estriol and lyophilized viable Lactobacillus acidophilus tablet appears effective for relieving GSM symptoms, reducing urogenital atrophy, and restoring vaginal flora [71].…”

Section: Available Treatmentsmentioning

confidence: 99%

Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause

2019

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Genitourinary syndrome of menopause is a condition comprising the atrophic symptoms and signs women may experience in the vulvovaginal and bladder-urethral areas as a result of the loss of sex steroids that occurs with menopause. It is a progressive condition that does not resolve without treatment and can adversely affect a woman’s quality of life. For a variety of reasons, many symptomatic women do not seek treatment and, of those who do, many are unhappy with their options. Additionally, many healthcare providers do not actively screen their menopausal patients for the symptoms of genitourinary syndrome of menopause. In this review, we discuss the clinical presentation of genitourinary syndrome of menopause as well as the treatment guidelines recommended by the major societies engaged in women’s health. This is followed by a review of available treatment options that includes both hormonal and non-hormonal therapies. We discuss both the systemic and vaginal estrogen products that have been available for decades and remain important treatment options for patients; however, a major intent of the review is to provide information on the newer, non-estrogen pharmacologic treatment options, in particular oral ospemifene and vaginal prasterone. A discussion of adjunctive therapies such as moisturizers, lubricants, physical therapy/dilators, hyaluronic acid, and laser therapy is included. We also address some of the available data on both the patient and healthcare providers perspectives on treatment, including cost, and touch briefly on the topic of treating women with a history of, or at high risk for, breast cancer.

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Quality of life and sexual function of naturally postmenopausal women on an ultralow-concentration estriol vaginal gel

Cited by 56 publications

References 33 publications

Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

Effects of vaginal administration of conjugated estrogens tablet on sexual function in postmenopausal women with sexual dysfunction: a double-blind, randomized, placebo-controlled trial

Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause

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