The genitourinary syndrome of menopause, also known as vulvovaginal atrophy, is characterized by changes in the female urogenital organs that occur in response to estrogen deficiency. It is a progressive condition that negatively affects the health, sexuality, and quality of life of many menopausal women.
On estet-portal.com, read what are the main clinical manifestations of genitourinary syndrome, why it occurs, as well as the most effective methods for its correction.
Genito-urinary syndrome of menopause: pathophysiology of changes
The vaginal epithelium contains a large number of estrogen receptors. Under the influence of endogenous estradiol, the epithelium becomes thicker, its blood supply and secretion increase.
During menopause, the concentration of female sex hormones decreases, resulting in genitourinary syndrome, which is manifested by atrophy of the epithelium, vaginal dryness and other extremely unpleasant symptoms.
However, genitourinary syndrome does not necessarily occur with age-related decline in ovarian secretion, but may be the result of other conditions accompanied by a decrease in estrogen levels.
Mechanism of development and symptoms of menopause in women
Clinical manifestations of genitourinary syndrome of menopause
Genitourinary syndrome is characterized by a polymorphic clinical picture. This condition may cause symptoms such as:
• dryness and narrowing of the vagina, especially in the absence of regular sexual activity;
• itching and burning in the external genital area;
• dyspareunia;
• atrophic changes in the genitals;
• contact bleeding;
• urination disorders: pollakiuria, urinary incontinence, cystalgia, etc.
Although about a third of middle-aged and older women report having these symptoms, very few seek specialist help. In this regard, the task of the doctor, when working with women during menopause, is to purposefully clarify whether they experience these uncomfortable sensations.
Read also: Urinary symptom of menopause: a new term in modern gynecology
During examination of the vulva, the clinician may note loss of subcutaneous fat in the area of the labia majora and labia minora and pigmentation. The vaginal epithelium may appear smooth (loose folding), shiny, and dry.
Non-hormonal treatment of genitourinary syndrome of menopause
Without active treatment, a patient with genitourinary syndrome may progressively worsen. Therefore, the appointment of non-hormonal treatment is mandatory for women with manifestations of this syndrome.
Regular sexual activity can help relieve symptoms and prevent progression of genitourinary syndrome.
For asymptomatic women, the use of over-the-counter water-based or silicone-based vaginal lubricants, which reduce the discomfort associated with friction during intercourse, may be advisable.
The use of laser therapy in the treatment of genitourinary menopausal syndrome
Treatment of genitourinary syndrome with systemic hormonal therapy
Systemic hormonal therapy is effective in the treatment of symptoms of atrophy of the genitourinary system, especially in severe clinical manifestations of the genitourinary syndrome. In case of insufficient effectiveness of systemic treatment, low doses of intravaginal estrogen can be added to therapy.
Modern studies show that low doses of intravaginal estrogens are also effective in eliminating dysuric symptoms, while systemic therapy, on the contrary, can aggravate urinary incontinence.
Based on the foregoing, the selection of the correct treatment for genitourinary syndrome allows the patient to provide comfort and a high quality of life during menopause.
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