J Menopausal Med.  2015 Aug;21(2):65-71. 10.6118/jmm.2015.21.2.65.

The Recent Review of the Genitourinary Syndrome of Menopause

Affiliations
  • 1Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea. mrkim@catholic.ac.kr

Abstract

The genitourinary syndrome of menopause (GSM) is a new term that describes various menopausal symptoms and signs including not only genital symptoms (dryness, burning, and irritation), and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function, but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). The terms vulvovaginal atrophy and atrophic vaginitis, which were generally used until recently, had a limitation because they did not cover the full spectrum of symptoms and did not imply that the symptoms are related to a decreased estrogen level in menopause. Since the GSM may have a profound negative impact on the quality of life of postmenopausal women, women should be made aware of these problems and treated with an appropriate effective therapy. Thus, in this review we introduce new terminology and discuss the importance of comprehension of GSM and the necessity of active treatment of this syndrome in postmenopausal women.

Keyword

Genitourinary syndrome of menopause; Menopause; Vulvovaginal atrophy

MeSH Terms

Atrophic Vaginitis
Atrophy
Burns
Comprehension
Dysuria
Estrogens
Female
Humans
Lubrication
Menopause*
Quality of Life
Urinary Tract
Estrogens

Cited by  4 articles

Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials
Arum Lee, Tae Hee Kim, Hae Hyeog Lee, Yeon Suk Kim, Temuulee Enkhbold, Bora Lee, Yoo Jin Park, Kisung Song
J Menopausal Med. 2018;24(1):1-10.    doi: 10.6118/jmm.2018.24.1.1.

Effect of Herbal Medicine on Vaginal Epithelial Cells: A Systematic Review and Meta-analysis
Yousef Rahmani, Khadijeh Chaleh Chaleh, Afshar Shahmohammadi, Shahla Safari
J Menopausal Med. 2018;24(1):11-16.    doi: 10.6118/jmm.2018.24.1.11.

Predictors of Acute Postoperative Urinary Retention after Transvaginal Uterosacral Suspension Surgery
Eun-Joo Son, Eunwook Joo, Woo Yeon Hwang, Mi Hyun Kang, Hyun Jin Choi, Eun-Hee Yoo
J Menopausal Med. 2018;24(3):163-168.    doi: 10.6118/jmm.2018.24.3.163.

Zinc-containing Vaginal Moisturizer Gel Improves Postmenopausal Vulvovaginal Symptoms: A Pilot Study
Peter Takacs, Bence Kozma, Balazs Erdodi, Attila Jakab, Kindra Larson, Robert Poka
J Menopausal Med. 2019;25(1):63-68.    doi: 10.6118/jmm.2019.25.1.63.


Reference

1. Portman DJ, Gass ML. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Menopause. 2014; 21:1063–1068.
2. Nappi RE, Kokot-Kierepa M. Women's voices in the menopause: results from an international survey on vaginal atrophy. Maturitas. 2010; 67:233–238.
3. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. Climacteric. 2012; 15:36–44.
4. Kingsberg SA, Wysocki S, Magnus L, Krychman ML. 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. 2013; 10:1790–1799.
5. Chae HD, Choi SY, Cho EJ, Cho YM, Lee SR, Lee ES, et al. Awareness and experience of menopausal symptom and hormone therapy in korean postmenopausal women. J Menopausal Med. 2014; 20:7–13.
6. Nappi RE, Palacios S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric. 2014; 17:3–9.
7. Tan O, Bradshaw K, Carr BR. Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: an up-to-date review. Menopause. 2012; 19:109–117.
8. Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause. 2008; 15:661–666.
9. Avis NE, Brockwell S, Randolph JF Jr, Shen S, Cain VS, Ory M, et al. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation. Menopause. 2009; 16:442–452.
10. Robinson D, Cardozo LD. The role of estrogens in female lower urinary tract dysfunction. Urology. 2003; 62:45–51.
11. Hyun HS, Park BR, Kim YS, Mun ST, Bae DH. Urodynamic characterization of postmenopausal women with stress urinary incontinence: retrospective study in incontinent pre- and post-menopausal women. J Korean Soc Menopause. 2010; 16:148–152.
12. Brown JS, Vittinghoff E, Kanaya AM, Agarwal SK, Hulley S, Foxman B. Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors. Obstet Gynecol. 2001; 98:1045–1052.
13. Raz R. Urinary tract infection in postmenopausal women. Korean J Urol. 2011; 52:801–808.
14. Lüthje P, Hirschberg AL, Brauner A. Estrogenic action on innate defense mechanisms in the urinary tract. Maturitas. 2014; 77:32–36.
15. Kim MY, Im SW, Park HM. The demographic changes of menopausal and geripausal women in Korea. J Bone Metab. 2015; 22:23–28.
16. Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010; 13:509–522.
17. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy's Impact On SEx and Relationships) survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med. 2013; 10:2232–2241.
18. The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013; 20:888–902. quiz 3–quiz 4.
19. Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in postmenopausal women. Cochrane Database Syst Rev. 2012; 10:Cd001405.
20. Beerepoot MA, Geerlings SE, van Haarst EP, van Charante NM, ter Riet G. Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and metaanalysis of randomized controlled trials. J Urol. 2013; 190:1981–1989.
21. Hong SN, Kim JH, Kim HY, Kim A. Effect of black cohosh on genital atrophy and its adverse effect in postmenopausal women. J Korean Soc Menopause. 2012; 18:106–112.
22. The North American Menopause Society. The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause. 2012; 19:257–271.
23. Brown JS, Grady D, Ouslander JG, Herzog AR, Varner RE, Posner SF. Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Heart & Estrogen/Progestin Replacement Study (HERS) Research Group. Obstet Gynecol. 1999; 94:66–70.
24. Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C, et al. Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005; 293:935–948.
25. Pinkerton JV, Stanczyk FZ. Clinical effects of selective estrogen receptor modulators on vulvar and vaginal atrophy. Menopause. 2014; 21:309–319.
26. Mirkin S, Komm BS. Tissue-selective estrogen complexes for postmenopausal women. Maturitas. 2013; 76:213–220.
27. Constantine G, Graham S, Portman DJ, Rosen RC, Kingsberg SA. Female sexual function improved with ospemifene in postmenopausal women with vulvar and vaginal atrophy: results of a randomized, placebo-controlled trial. Climacteric. 2015; 18:226–232.
28. Portman DJ, Bachmann GA, Simon JA. Ospemifene, a novel selective estrogen receptor modulator for treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy. Menopause. 2013; 20:623–630.
29. Simon JA, Lin VH, Radovich C, Bachmann GA. One-year long-term safety extension study of ospemifene for the treatment of vulvar and vaginal atrophy in postmenopausal women with a uterus. Menopause. 2013; 20:418–427.
30. Archer DF. Tissue-selective estrogen complexes: a promising option for the comprehensive management of menopausal symptoms. Drugs Aging. 2010; 27:533–544.
31. Lobo RA, Pinkerton JV, Gass ML, Dorin MH, Ronkin S, Pickar JH, et al. Evaluation of bazedoxifene/conjugated estrogens for the treatment of menopausal symptoms and effects on metabolic parameters and overall safety profile. Fertil Steril. 2009; 92:1025–1038.
32. Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014; 124:1147–1156.
33. Grimaldi EF, Restaino S, Inglese S, Foltran L, Sorz A, Di Lorenzo G, et al. Role of high molecular weight hyaluronic acid in postmenopausal vaginal discomfort. Minerva Ginecol. 2012; 64:321–329.
34. Chen J, Geng L, Song X, Li H, Giordan N, Liao Q. Evaluation of the efficacy and safety of hyaluronic acid vaginal gel to ease vaginal dryness: a multicenter, randomized, controlled, open-label, parallel-group, clinical trial. J Sex Med. 2013; 10:1575–1584.
35. Johnston SL, Farrell SA, Bouchard C, Farrell SA, Beckerson LA, Comeau M, et al. The detection and management of vaginal atrophy. J Obstet Gynaecol Can. 2004; 26:503–515.
36. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2006; Cd001500.
37. Sinha A, Ewies AA. Non-hormonal topical treatment of vulvovaginal atrophy: an up-to-date overview. Climacteric. 2013; 16:305–312.
Full Text Links
  • JMM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr