Genitourinary menopausal syndrome – problem for women of elegant age and not only

Authors

DOI:

https://doi.org/10.18370/2309-4117.2016.28.68-74

Keywords:

genitourinary menopausal syndrome, vulvovaginal atrophy, estriol, Ovestin®

Abstract

Urogenital disorders are caused by atrophic and degenerative processes in estrogen-dependent tissues (bladder, urethra, vagina), as well as ligaments and the pelvic muscles, and lead to a disorders in the sexual sphere of women. Unlike classic menopausal symptoms – hot flushes, which regress after 5–10 years after menopause, vulvovaginal atrophy symptoms in most women of the menopausal period are progressing.

Experts of the International Society for the Study of Women’s Sexual Health (ISSWSH) and North American Menopause Society (NAMS) proposed to replace the currently used term “vulvovaginal atrophy” with the term “genitourinary menopausal syndrome”. The processes of urogenital aging are developing in two directions: development of atrophic vaginitis and development of atrophic cystourethritis with disorders of urination control or without it.

Estrogen therapy is the standard pathogenic treatment for this disease. Because of the possible risks of systemic hormone replacement therapy, topical estrogen application in women with genitourinary menopausal syndrome is a more acceptable and allows treating women older than 60 or 10 years after menopause.

A study to examine the effectiveness of estriol-containing drug for topical treatment of vulvovaginal atrophy was performed. The study included 30 patients aged over 50 years.

Intravaginal treatment of atrophic vaginitis with estriol (Ovestin® drug) was carried out as monotherapy duration of 30 days. Evaluation of efficacy and safety of treatment was based on the dynamics of clinical, microbiological, colposcopic, colpocytologic data and ultrasound screening of endometrium thickness before and after the end of therapy.

The results showed high efficacy and safety of topical therapy of atrophic processes in the lower genital tract with estriol (Ovestin® drug). This allows us to recommend this type of therapy as a method to preserve the health of postmenopausal women and significantly improve their life quality.

Author Biographies

Л. В. Калугина, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

MD, leading researcher of the Endocrine Gynecology Department

Т. Ф Татарчук, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

MD, professor, corresponding member. NAMS of Ukraine, Deputy Director for Research, Head of Endocrine Gynecology

О. В. Занько, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

Graduate student of the Endocrine Gynecology Department

References

  1. National consensus on management patients in menopause // Reproductive Endocrinology 1.27 (2016): 8–25.
  2. Glazunova, A.V., Yureneva, S.V., Yezhova, L.S. “Vulvovaginal atrophy: the symptoms, impact on the emotional well-being, quality of life and sexual function.” Obstetrics and gynecology 2 (2015): 27–32.
  3. Romashchenko, O.V., Melnikov, S.N. “Urogenital disorders of menopause. Part 1: etiology, pathogenesis, diagnosis.” ORZHIN 2 (2008): 4–6.
  4. Kostava, M.N., Bashirova, L.K. “Atrophic exocervicitis and vaginitis. Features therapy.” Consilium Medicum 2.12 (2010).
  5. Kolomiets, L.M. “Local estrogen: not only for treatment but also for diagnostics.” Reproductive Endocrinology 3.11 (2013): 46–50.
  6. Tatarchuk, T.F., Yefymenko O.A., Islamova, A.O. “Menopause: A new look at an old problem.” Reproductive Endocrinology 1.9 (2013): 7–12.
  7. Tatarchuk, T.F., Yefymenko O.A. “The principles of diagnosis, prevention and treatment of menopausal disorders.” Journal of Ukrainian Medical Elite 4.10 (2009): 24–29.
  8. Anderson, G.L., Chlebowski, R.T., Aragaki, A.K., et al. “Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women’s Health Initiative randomised placebo-controlled trial.” Lancet Oncol 13.5 (2012): 476–86.
  9. Bachmann, G., Bouchard, C., Hoppe, D., et al. “Efficacy and safety of low-dose regimens of conjugated estrogens cream administered vaginally.” Menopause 16.4 (2009): 719–27.
  10. Barlow, D.H., Samsioe, G., van Geelen, I.M. “A study of European women experience of the problems of urogenital aging and its management.” Maturitas 27.3 (1997): 239–247.
  11. Bulten, J., de Wilde, P.C.M., Boonstra, H., et al. “Proliferation in “Atypical” Atrophic Pap Smears.” Gynecologic Oncology 79 (2000): 225–9.
  12. Eugster-Hausmann, M., Waitzinger, J., Lehnick, D. “Minimized estradiol absorption with ultra-low-dose 10 mg 17β-estradiol vaginal tablets.” Climacteric 13.3 (2010): 219–27.
  13. Frank, S.M., Ziegler, C., Kokot-Kierepa, M., et al. “Vaginal health: insights, views & attitudes (VIVA) survey – Canadian cohort.” Menopause Int 11 (2012).
  14. Harman, S.M., Black, D.M., Naftolin, F., et al. “Arterial imaging outcomes and cardiovascular risk factors in recently menopausal women: a randomized trial.” Ann Intern Med 161.4 (2014): 249–60.
  15. Lindau, S.T., Schumm, L.P., Laumann, E.O., et al. “A study of sexuality and health among older adults in the United States.” N Engl J Med 357.8 (2007): 762–74.
  16. Kingsberg, S.A., Krychman, M.L. “Resistance and barriers to local estrogen therapy in women with atrophic vaginitis.” J Sex Med 10.6 (2013): 1567–74.
  17. Kingsberg, S.A., Wysocki, S., Magnus, L., Krychman, M.L. “Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (Real Women’s Views of Treatment Options for Menopausal Vaginal Changes) survey.” J Sex Med 10.7 (2013): 1790–9. DOI: 10.1111/jsm.12190
  18. The North American Menopause Society. “Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society.” Menopause 20.9 (2013): 888–902.
  19. Manson, J.E., Chlebowski, R.T., Stefanick, M.L., et al. “Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials.” JAMA 310.13 (2013): 1353–68.
  20. Nappi, R.E., Kokot-Kierepa, M. “Women’s voices in the menopause: results from an international survey on vaginal atrophy.” Maturitas 7.3 (2010): 233–8.
  21. Santoro, N., Komi, J. “Prevalence and impact of vaginal symptoms among postmenopausal women.” J Sex Med 6(2009): 2133–42.
  22. Simon J.A., Kokot-Kierepa, M., Goldstein, J., Nappi, R.E. “Vaginal health in the United States: results from the Vaginal Health: Insights, Views & Attitudes survey.” Menopause 20.10 (2013): 1043–8. DOI: 0.1097/GME.0b013e318287342d
  23. Sturdee, D.W., Panay, N. “Recommendations for the management of postmenopausal vaginal atrophy.” Climacteric 13 (2010): 509–22.
  24. Wills, S., Ravipati, A., Venuturumilli, P., et al. “Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator.” J Oncol Pract 8.3 (2012): 144–8.
  25. Wysocki, S., Kingsberg, S., Krychman, M. “Management of Vaginal Atrophy: Implications from the REVIVE Survey.” Clinical Medicine Insights: Reproductive Health 8 (2014): 23–30.

Published

2016-04-21

How to Cite

Калугина, Л. В., Татарчук, Т. Ф., & Занько, О. В. (2016). Genitourinary menopausal syndrome – problem for women of elegant age and not only. REPRODUCTIVE ENDOCRINOLOGY, (28), 68–74. https://doi.org/10.18370/2309-4117.2016.28.68-74

Issue

Section

Management of menopause