Modern Management of Genitourinary Syndrome of Menopause

Overview

Journal Fac Rev

Specialty Biomedical Engineering

Date 2021 Mar 15

PMID 33718942

Citations 4

Authors

Ana Sofia Da Silva

Georgina Baines

George Araklitis

Dudley Robinson

Linda Cardozo

Affiliations

Soon will be listed here.

Abstract

The genitourinary syndrome of menopause (GSM) is the accepted term used to describe the broad spectrum of genitourinary tract symptoms and signs caused by the loss of endogenous sex steroids that occurs at the time of and after the menopause. Global improvements in healthcare have resulted in an ageing population. Today, women are spending 40% of their lives in the postmenopausal state, and with 50-70% of postmenopausal women reporting symptomatic GSM, safe and efficacious treatments are needed for this troublesome condition. This article reviews current evidence for non-pharmacological and pharmacological treatments with a focus on novel and minimally invasive procedures such as energy-based devices (CO laser, YAG laser), hyaluronic acid, dehydroepiandrosterone, and selective oestrogen receptor modulators.

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References

Gambacciani M, Palacios S . Laser therapy for the restoration of vaginal function. Maturitas. 2017; 99:10-15. DOI: 10.1016/j.maturitas.2017.01.012. View

Pitsouni E, Grigoriadis T, Douskos A, Kyriakidou M, Falagas M, Athanasiou S . Efficacy of vaginal therapies alternative to vaginal estrogens on sexual function and orgasm of menopausal women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2018; 229:45-56. DOI: 10.1016/j.ejogrb.2018.08.008. View

Lethaby A, Ayeleke R, Roberts H . Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016; (8):CD001500. PMC: 7076628. DOI: 10.1002/14651858.CD001500.pub3. View

Simon J, Altomare C, Cort S, Jiang W, Pinkerton J . Overall Safety of Ospemifene in Postmenopausal Women from Placebo-Controlled Phase 2 and 3 Trials. J Womens Health (Larchmt). 2017; 27(1):14-23. PMC: 5771532. DOI: 10.1089/jwh.2017.6385. View

Nappi R, Kokot-Kierepa M . Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. Climacteric. 2011; 15(1):36-44. DOI: 10.3109/13697137.2011.647840. View

Sanchez-Borrego R, Manubens M, Navarro M, Cancelo M, Beltran E, Duran M . Position of the Spanish Menopause Society regarding vaginal health care in postmenopausal women. Maturitas. 2014; 78(2):146-50. DOI: 10.1016/j.maturitas.2014.03.003. View

Karcher C, Sadick N . Vaginal rejuvenation using energy-based devices. Int J Womens Dermatol. 2017; 2(3):85-88. PMC: 5418869. DOI: 10.1016/j.ijwd.2016.05.003. View

Murina F, Di Francesco S, Oneda S . Vulvar vestibular effects of ospemifene: a pilot study. Gynecol Endocrinol. 2018; 34(7):631-635. DOI: 10.1080/09513590.2018.1427717. View

Moral E, Delgado J, Carmona F, Caballero B, Guillan C, Gonzalez P . Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study. Climacteric. 2018; 21(2):167-173. DOI: 10.1080/13697137.2017.1421921. View

10.

Baber R, Panay N, Fenton A . 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2):109-50. DOI: 10.3109/13697137.2015.1129166. View

11.

Briggs P . Genitourinary syndrome of menopause. Post Reprod Health. 2019; 26(2):111-114. DOI: 10.1177/2053369119884144. View

12.

Portman D, Palacios S, Nappi R, Mueck A . Ospemifene, a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial. Maturitas. 2014; 78(2):91-8. DOI: 10.1016/j.maturitas.2014.02.015. View

13.

Salvatore S, Nappi R, Zerbinati N, Calligaro A, Ferrero S, Origoni M . A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric. 2014; 17(4):363-9. DOI: 10.3109/13697137.2014.899347. View

14.

Alvisi S, Baldassarre M, Martelli V, Gava G, Seracchioli R, Meriggiola M . Effects of ospemifene on vaginal epithelium of post-menopausal women. Gynecol Endocrinol. 2017; 33(12):946-950. DOI: 10.1080/09513590.2017.1332589. View

15.

Archer D, Kimble T, Lin F, Battucci S, Sniukiene V, Liu J . A Randomized, Multicenter, Double-Blind, Study to Evaluate the Safety and Efficacy of Estradiol Vaginal Cream 0.003% in Postmenopausal Women with Vaginal Dryness as the Most Bothersome Symptom. J Womens Health (Larchmt). 2017; 27(3):231-237. PMC: 5865261. DOI: 10.1089/jwh.2017.6515. View

16.

Robinson D, Flint R, Veit-Rubin N, Araklitis G, Cardozo L . Is there enough evidence to justify the use of laser and other thermal therapies in female lower urinary tract dysfunction? Report from the ICI-RS 2019. Neurourol Urodyn. 2020; 39 Suppl 3:S140-S147. DOI: 10.1002/nau.24298. View

17.

Najjarzadeh M, Mohammad Alizadeh Charandabi S, Mohammadi M, Mirghafourvand M . Comparison of the effect of hyaluronic acid and estrogen on atrophic vaginitis in menopausal women: A systematic review. Post Reprod Health. 2019; 25(2):100-108. DOI: 10.1177/2053369119830818. View

18.

Palma F, Xholli A, Cagnacci A . The most bothersome symptom of vaginal atrophy: Evidence from the observational AGATA study. Maturitas. 2018; 108:18-23. DOI: 10.1016/j.maturitas.2017.11.007. View

19.

Bell R, Rizvi F, Islam R, Davis S . A systematic review of intravaginal testosterone for the treatment of vulvovaginal atrophy. Menopause. 2017; 25(6):704-709. DOI: 10.1097/GME.0000000000001052. View

20.

Palacios S, Combalia J, Emsellem C, Gaslain Y, Khorsandi D . Therapies for the management of genitourinary syndrome of menopause. Post Reprod Health. 2019; 26(1):32-42. DOI: 10.1177/2053369119866341. View