Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause

被引:60
作者
Kagan, Risa [1 ]
Kellogg-Spadt, Susan [2 ,3 ]
Parish, Sharon J. [4 ]
机构
[1] Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, Sutter East Bay Med Fdn, Sutter East Bay Med Grp, 2500 Milvia St, Berkeley, CA 94704 USA
[2] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA
[3] Ctr Pelv Med, Bryn Mawr, PA USA
[4] Weill Cornell Med Coll, New York, NY USA
关键词
VULVO-VAGINAL ATROPHY; WOMENS SEXUAL HEALTH; QUALITY-OF-LIFE; POSTMENOPAUSAL WOMEN; TREATMENT OPTIONS; BAZEDOXIFENE/CONJUGATED ESTROGENS; INTERNATIONAL SOCIETY; SYMPTOMS; EFFICACY; THERAPY;
D O I
10.1007/s40266-019-00700-w
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
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.
引用
收藏
页码:897 / 908
页数:12
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