scholarly journals Characteristics of post-menopausal women with genitourinary syndrome of menopause: Implications for vulvovaginal atrophy diagnosis and treatment selection

Maturitas ◽  
2015 ◽  
Vol 81 (4) ◽  
pp. 462-469 ◽  
Author(s):  
Camil Castelo-Branco ◽  
Nicoletta Biglia ◽  
Rossella E. Nappi ◽  
Anne Schwenkhagen ◽  
Santiago Palacios
Keyword(s):  
Treatment Selection ◽  
Diagnosis And Treatment ◽  
Genitourinary Syndrome Of Menopause ◽  
Vulvovaginal Atrophy ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome

scholarly journals Association of Vaginal Microbiota With the Genitourinary Syndrome of Menopause Across Reproductive Stages

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 171-171
Author(s):  
Michelle Shardell ◽  
Patti Gravitt ◽  
Jacques Ravel ◽  
Anne Burke ◽  
Rebecca Brotman
Keyword(s):  
Relative Abundance ◽  
Female Genital Tract ◽  
Signs And Symptoms ◽  
Vaginal Microbiota ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome ◽  
Lactobacillus Spp

Abstract The genitourinary syndrome of menopause (GSM) is a collection of signs and symptoms related to estrogen decline that involves physical changes to the vulva, vagina, and lower urinary tract. GSM signs and symptoms may occur during any reproductive stage but are most common during menopause. Vaginal microbiota, particularly Lactobacillus spp., protect the female genital tract from multiple conditions; however, Lactobacillus spp. abundance declines during menopause. We aimed to determine the longitudinal association of vaginal microbiota with GSM signs and symptoms across reproductive stages. In a two-year cohort study comprising 750 women aged 35-60 years who contributed 2111 semiannual person-visits, low-Lactobacillus spp. vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and post-menopausal women, respectively (p<.001). After covariate adjustment, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were associated with vulvovaginal atrophy relative to high-Lactobacillus spp. communities dominated by L. crispatus (OR[Odds Ratio]=3.04, 95% Confidence Interval[CI]=1.02-9.06) among post-menopausal, but not among peri- or pre-menopausal women. Also, post-menopausal women with low-Lactobacillus spp. communities reported decreased libido (OR=1.79, 95%CI=1.04-3.12) and vaginal dryness (OR=1.61, 95%CI=0.89-2.90) more frequently than their counterparts with high-Lactobacillus spp. communities, but not among peri- or pre-menopausal women (p for interaction<.05). Specifically, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were related to both decreased libido (OR=2.82, 95%CI=1.11-7.14) and vaginal dryness (OR=3.50, 95%CI=1.18-10.44) compared with high-Lactobacillus spp. communities dominated by L. gasseri/L. jensenii. Vaginal microbiota, particularly Lactobacillus spp., and menopause may synergistically influence GSM.

scholarly journals Efficacy and Safety of Laser Therapy for the Treatment of Genitourinary Syndrome of Menopause: A Protocol for Systematic Review and Meta-Analysis of Clinical Trials

2021 ◽  
Vol 3 ◽  
Author(s):  
Lisieux de Lourdes Martins Nóbrega Pessoa ◽  
Ayane Cristine Alves Sarmento ◽  
Kleyton Santos Medeiros ◽  
Ana Paula Ferreira Costa ◽  
Ana Katherine Gonçalves ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laser Therapy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Efficacy And Safety ◽  
Bias Assessment ◽  
Genitourinary Syndrome Of Menopause ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome

Laser therapy has been proposed to improve the symptoms of genitourinary syndrome of menopause (GSM), especially in women who do not accept hormonal therapy or are at a high risk of complications if they undergo hormonal therapy. However, studies evaluating the effectiveness and safety of laser treatment for GSM have shown controversial results. Thus, we aimed to determine the efficacy and safety of laser therapy in post-menopausal women with GSM. We have developed a protocol according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol using the population, intervention, comparison, outcome, and study design (PICOS) framework for post-menopausal women who have received no treatment, laser therapy, placebo, or vaginal estrogen for GSM. As per our protocol, randomized controlled trials and quasi-randomized trials, regardless of language of publication, will be searched in PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and clinicaltrials.gov. Gray literature will be searched in Open Gray and Google Scholar. The reference lists will be scanned for additional trials, and the authors will be contacted if necessary. Outcome data reported in a trial registry, even when no published results were available, will be analyzed. The search will be performed using key terms, such as “post-menopausal women,” “menopausal genitourinary syndrome,” “vulvovaginal atrophy,” and “laser therapy.” Two review authors will independently screen the titles and abstracts, while three others will independently evaluate the full text of each study to determine its eligibility for this systematic review (SR). Any disagreement will be resolved through discussion and consensus. Data extraction will be performed independently using a standardized data collection form. Clinical outcomes, including vaginal atrophy, vaginal pH, dryness, dyspareunia, itching, burning, dysuria, urinary frequency, urinary urgency, and urinary incontinence, will be systematically evaluated. We will not perform a separate search for adverse effects; instead, we will consider the adverse effects described in the included studies. Furthermore, we will summarize the effects of dichotomous outcomes as risk ratios with 95% confidence intervals. On the other hand, continuous outcomes will be summarized by expressing treatment effects as a mean difference with standard deviation or as a standardized mean difference when different scales were used to measure the same outcome. We will use the Cochrane Risk of Bias 2 tool for bias assessment and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the overall certainty of evidence. Review Manager 5.3.5 will be used for quantitative data synthesis, subgroup analysis, sensitivity analysis, meta-regression, and risk of bias assessment. The SR findings will provide highly relevant evidence through the synthesis of well-designed and robust clinical trials on the effectiveness and safety of laser therapy in GSM. The Prospective Register of Systematic Reviews (PROSPERO) registration number (2021) of the SR is CRD42021253605.

Diagnosis and Treatment of Genitourinary Syndrome of Menopause

2018 ◽  
Vol 22 (5) ◽  
pp. 423-430 ◽  
Author(s):  
Ashley L. Hodges ◽  
Aimee C. Holland ◽  
Barbara Dehn ◽  
Diane T. Pace
Keyword(s):  
Diagnosis And Treatment ◽  
Genitourinary Syndrome Of Menopause ◽  
Genitourinary Syndrome

Non-hormonal treatment for genitourinary syndrome of menopause

2021 ◽  
Vol 20 (2) ◽  
pp. 141-146
Author(s):  
N.A. Tatarova ◽  
◽  
V.A. Linde ◽  
S.N. Gusev ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hormonal Treatment ◽  
Therapeutic Effects ◽  
Life Questionnaire ◽  
Genitourinary Syndrome Of Menopause ◽  
Quality Of Life Questionnaire ◽  
Vulvovaginal Atrophy ◽  
Positive Effects ◽  
Genitourinary Syndrome

The genitourinary syndrome of menopause (GSM) is due to the development of atrophic and dystrophic processes in estrogendependent tissues and structures of the lower third of urinary tract in different periods of aging of the reproductive system. Nonhormonal treatment for GSM is considered as a first-line treatment and includes the use of gels, creams and suppositories that contribute to the restoration of hydrolipid balance, stimulating the collagen production that have an anti-inflammatory, antiseptic, regenerating effect, as well as increasing mucosal resistance and reducing the risk of adhesion of conditionally pathogenic infection. Objective. To evaluate the effectiveness, safety and acceptability of the vaginal cream for intimate hygiene EstrogialTM Plus in women with symptoms of vulvovaginal atrophy (VVA) and GSM. Patients and methods. 24 women aged 43 to 58 were examined. The inclusion criteria were the symptoms of GSM and VVA, the vaginal health index – no more than 20 points. During the course of the study, four visits were carried out, including standard observational procedures, filling the Quality of Life Questionnaire, the administration of treatment. The application of the cream Estrogial™ Plus in doses was prescribed 1 time per day on the vulvar vestibule for 30 days. The effectiveness of therapy was evaluated, all patients continued therapy for up to 60 days. According to the modified questionnaire for general clinical assessment, the state «very much improved» was revealed in 83.3% of patients with a severe form of GSM and VVA and in 66.7% with moderate VVA, «much improved» – in the rest. After treatment, 52% of patients had no symptoms of VVA, and 48% had symptoms in a mild form. Filling the Menopause-Specific Quality of Life Questionnaire (MENQOL), all 24 patients reported positive effects in the form of increased libido and reduced vaginal dryness during sexual intercourses. The study presents clinical cases of cured patients with GSM and VVA. Conclusion. The data obtained during the study make it possible to conclude that the intravaginal administration of the cream EstrogialTM Plus in doses is effective for the treatment of GSM and VVA. The proven therapeutic effects and safety of the use of local non-hormonal treatment enhance the prospects for providing treatment and preventive care for women during the menopausal transition and menopause. Key words: vulvovaginal atrophy, genitourinary syndrome of menopause, non-hormonal treatment, Estrogial™ Plus

scholarly journals Vulvar Craurosis due to Severe Genitourinary Syndrome of Menopause Complicated by Lichen Sclerosus: Two Case Reports and Literature Review

2021 ◽  
Vol 5 (9) ◽  
pp. 01-04
Author(s):  
Marta Pérez Febles ◽  
Victoria Pascual Escudero ◽  
Sonia De Miguel Manso ◽  
María López Pais ◽  
Dakota Viruega Cuaresma ◽  
...  
Keyword(s):  
Case Reports ◽  
Symptom Relief ◽  
Lichen Sclerosus ◽  
Clinical Situation ◽  
Term Treatment ◽  
Genitourinary Syndrome Of Menopause ◽  
Vulvovaginal Atrophy ◽  
Inflammatory Dermatoses ◽  
Long Term Treatment ◽  
Genitourinary Syndrome

Background: Vulvovaginal atrophy affects approximately 45% of middle-aged women, as a result of decreased estrogen circulating levels and is often associated with vulvovaginal discomfort in menopausal patients. The spectrum of adverse consequences makes long-term treatment essential, not only for symptom relief, but also to avoid further complications. These symptoms can even be worsened if other vulvar conditions coexist, such as inflammatory dermatoses. Clinical presentation: We present two cases of patients with severe vulvar atrophy and craurosis, who required vulvo-vaginal opening associated with medical treatment. In both patients, we diagnosed severe genitourinary syndrome of menopause (GSM) complicated by vulvar lichen sclerosus, a very rare clinical situation. In case 1, the symptoms had progressed despite local estrogen treatment for vulvovaginal atrophy, and lichen wasn’t considered in previous check-ups. In contrast, patient nº 2 presented in the ER with impossibility to urinate and was then diagnosed and treated for underlying causes. Conclusions: GSM treatment should be a priority. The absence of improvement or progression of genital atrophy should alert the specialist to the coexistence of other vulvar pathologies.

scholarly journals Safety and efficacy of a new vaginal gel, Feminilove, for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women: an in vitro and in vivo study

2021 ◽  
Author(s):  
Albert Gonzalez ◽  
Robert Lee ◽  
Larry Booshehri ◽  
David Grady ◽  
Victoria Vaddi ◽  
...  
Keyword(s):  
Vaginal Mucosa ◽  
Minimal Cell ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Vulvovaginal Atrophy ◽  
Vaginal Gel ◽  
The Impact ◽  
Genitourinary Syndrome

Vaginal dryness is a common condition that is particularly prevalent during and after the menopause and it is one of the most important symptoms associated with vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underreported and undertreated. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. We evaluated the safety and beneficial effects of a new type of estrogen-free vaginal gel, Feminilove BIO-FRESH moisturizing vaginal gel, using in vitro and in vivo experimental tools. Our results suggest that; 1) Feminilove vaginal gel exhibits minimal cell cytotoxicity on various human vaginal cells; 2) Feminilove vaginal gel exhibits minimal side-effects on the structure of vaginal mucosa stratum of experimental animals; 3) Feminiove vaginal gel inhibits the growth of pathogenic vaginal bacteria (E. coli) while promotes the growth of beneficial vaginal bacteria (Lactobacillus spp); 4) Feminilove vaginal gel elicits an anti-inflammatory response on vaginal epithelial cells; and 5) Feminilove vaginal gel promotes the production of tropoelastin and collagen on cultural vaginal smooth muscle and may restore loose vaginal wall (i.e., tightening effects). In summary, our results indicate that Feminilove BIO-FRESH moisturizing vaginal gel is a safe and effective remedy for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women. Keyword: vaginal dryness, vulvovaginal atrophy, genitourinary syndrome of menopause, sexual dysfunction, vaginal lubrication, vaginal moisturizer

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