![]() Laser treatment is a novel non-hormonal treatment approach for GSM. Moreover, many women prefer not to use hormonal therapy due to side effects, such as worsening of the symptoms of urinary incontinence. 9 Local estrogen treatment for this group of women remains controversial. 8 Breast cancer treatment increases the prevalence of GSM symptoms, which negatively correlate with quality of life. Systemic estrogen therapy is sometimes used however, 10%–20% of women may have residual GSM symptoms even while taking systemic estrogen. 1 Vaginal estrogen appears to relieve symptoms more effectively than non-hormonal gels. While non-hormonal vaginal moisturizers and lubricants can be safely used for GSM symptoms, they need to be used regularly for optimal effect. Therefore, NAMS noted thatĬhoice of therapy depends on the severity of symptoms, the effectiveness and safety of therapy for the individual patient, and patient preference. 7 However, they further stated that endometrial safety has not been studied in long-term clinical studies, and there are insufficient data to confirm the safety of local estrogen in women with breast cancer. The North American Menopause Society (NAMS) updated its position statement in 2013 on the management of symptomatic GSM in postmenopausal women to conclude that non-hormonal therapies provide relief for mild symptoms, while estrogen therapy is the most effective treatment for moderate to severe symptoms. 6Ĭurrent therapeutic approaches include topical treatments and hormones. ![]() Findings from the Real Women’s Views on Treatment Options for Menopausal Vaginal Changes survey reported that these symptoms affected sexual satisfaction in 59% of women responding to the survey in nearly one-fourth (23%) of respondents, these symptoms affected general temperament and general life enjoyment. 5 Many women with sexual health concerns are not aware that the changes in genitourinary anatomy and physiology that occur with age can impact sexual functioning. As sexual health is an important aspect of overall health that changes over a woman’s lifetime, problems in sexual health may adversely affect quality of life. Thinning of the epithelial lining and loss of lubrication during intercourse contribute to dyspareunia and can have a detrimental effect on sexual gratification. 4 Clinical findings include the presence of pale and dry vulvovaginal mucosa with petechiae. 1 – 3 According to the Vulvovaginal Atrophy Terminology Consensus Conference Panel, genitourinary syndrome of menopause (GSM) is a more medically accurate term for VVA and includes genital symptoms, as well as sexual symptoms of lack of lubrication, discomfort or pain, and impaired function and urinary symptoms of urgency, dysuria, and recurrent urinary tract infections. 1 Self-reported genital symptoms include dryness, irritation, soreness, and associated dyspareunia. Although the prevalence varies in early premenopausal to late postmenopausal women, vulvovaginal atrophy (VVA) is considered to be a common and underreported condition, with nearly 50% of postmenopausal women reporting symptoms.
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