menopausal genitourinary syndrome
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Introduction
A terms referenced by the North American Menopause Society
Epidemiology
- most common cause of post-menopausal vaginal bleeding (60%)
Clinical manifestations
- includes atrophic vaginitis*
- vaginal bleeding
* not clear what else it might include
Management
- vaginal lubricants 1st line[2]
- except if urinary symptoms, then vaginal estrogen[5]
- vaginal estrogen[1]
- vaginal estrogen (conjugated estrogen cream, 0.5 g intravaginally daily for 14 days followed by 0.5 g twice weekly
- women with urinary symptoms may benefit more from topical estrogen therapy[5]
- fractionated CO2 laser therapy for selected patients[3]
- 3 intravaginal treatments at least 6 weeks apart
- ospemifene a selective estrogen receptor modulator is FDA approved for treatment of dyspareunia & moderate to severe genitourinary syndrome of menopause -adverse effects of hot flashes & risk for venous thromboembolism
More general terms
References
- ↑ 1.0 1.1 North American Menopause Society The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017 Jul;24(7):728-753 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28650869 <Internet> http://www.menopause.org/docs/default-source/2017/nams-2017-hormone-therapy-position-statement.pdf
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19 American College of Physicians, Philadelphia 2015, 2018, 2022
- ↑ 3.0 3.1 Paraiso MFR, Ferrando CA, Sokol ER et al. A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial. Menopause 2020 Jan; 27:50-56. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31574047 https://journals.lww.com/menopausejournal/Abstract/2020/01000/A_randomized_clinical_trial_comparing_vaginal.9.aspx
- ↑ Rahn DD, Carberry C, Sanses TV et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124(6):1147-1156 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25415166 PMCID: PMC4855283 Free PMC article https://journals.lww.com/greenjournal/Abstract/2014/12000/Vaginal_Estrogen_for_Genitourinary_Syndrome_of.12.aspx
- ↑ 5.0 5.1 5.2 The North American Menopause Society (NAMS). The 2020 Genitourinary Syndrome of Menopause Position Statement of the North American Menopause Society. Menopause. 2020;27(9): 976-992 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32852449 https://journals.lww.com/menopausejournal/Abstract/2020/09000/The_2020_genitourinary_syndrome_of_menopause.5.aspx