Efficacy of vaginal therapies alternative to vaginal estrogens on sexual function and orgasm of menopausal women: A systematic review and meta-analysis of randomized controlled trials

Pitsouni, Eleni; Grigoriadis, Themos; Douskos, Athanasios; Kyriakidou, Margarita; Falagas, Matthew E.; Athanasiou, Stavros

doi:10.1016/j.ejogrb.2018.08.008

Cited by 42 publications

(32 citation statements)

References 61 publications

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“…This treatment is more pronounced and lasts longer than treatment with topical estriol 15,16,20,32,38,40,41,43,44,48 . The results obtained in the present review are in line with the results obtained in previous reviews, 3,59‐61 where it was observed that the CO 2 / YAG laser may be effective in treating GSM, reducing the severity of symptoms of VVA, restoring the vaginal mucosa, and thus improving the quality of life of these women. The studies also pointed out that laser therapy in the urological area can be a useful substitute and a promising complement for therapies that are not well accepted by patients, such as the administration of hormones, pelvic floor exercises, or surgery.…”

Section: Discussionsupporting

confidence: 91%

“…Previous reviews that assessed randomized controlled trials and observational studies also found evidence suggesting that laser treatment improves vaginal health, vaginal atrophy, and symptoms of urinary incontinence 3,59‐61 . However, it is believed that no previous review has been conducted on studies using radiofrequency.…”

Section: Discussionmentioning

confidence: 99%

“…The authors of these studies used inclusion criteria that were different from those used in the present study, and thus their search was less comprehensive. It is important to note that most reviews are focused on assessing sexual function, 60,61 which was not the objective of the present study. Finally, it is important to note that none of the reviews previously carried out addressed data on the use of radiofrequency.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Sarmento

Lírio

Medeiros

et al. 2021

Intl J Gynecology & Obste

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Background Genitourinary syndrome of menopause (GSM) negatively affects sexual function and quality of life. Techniques like laser and radiofrequency are being used to manage GSM, particularly in women with contraindications for hormone therapy. Objectives To verify whether the physical methods of laser and radiofrequency can be recommended as safe and effective options for the treatment of GSM/urinary urgency or incontinence in pre‐ and postmenopausal women. Search strategy Databases were comprehensively searched using combinations of the following keywords in any language: “postmenopause”; “genitourinary syndrome of menopause”; “vaginal atrophy”; “radiofrequency”; and “laser.” Selection criteria Full articles of case‐control, cross‐sectional, cohort, randomized clinical trials, and quasi‐randomized or controlled clinical trials were included. Data collection and analysis All authors independently evaluated the design of the studies for quality of reporting, risk of bias, and quality of evidence. Main results Of the included 49 studies, 37 were on the CO2 laser, 10 on the Erbium laser, and two on radiofrequency. Conclusions Laser and radiofrequency therapy could be promising and safe therapeutic options for GSM/urinary incontinence. However, the study findings cannot be generalized until new randomized clinical trials are performed that confirm the strength of the evidence. This review has been registered with PROSPERO: CRD42020141913.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Sarmento

Lírio

Medeiros

et al. 2021

Intl J Gynecology & Obste

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“…In 2018, a meta-analysis of sexuality scores in RCTs comparing moisturizers and lubricants to vaginal estrogens [80] indicated an inferior impact of non-hormonal vs. hormonal local treatments on sexuality scores; nevertheless, dyspareunia was significantly improved also with non-hormonal therapies. It is worth noting that the authors concluded that the small number of subjects considered, including breast cancer survivors, was insufficient to provide definitive conclusions [80].…”

Section: Treatment Options For Menopause—related Sexual Dysfunctionsmentioning

confidence: 99%

Sexual Health in Menopause

et al. 2019

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Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.

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“…Vaginal vitamin E is involved in the metabolism of all cells and prevents tissue damage caused by oxidants. This facilitates blood circulation, which consequently increases the metabolism of vaginal connective tissues and enhances the moisture and flexibility of vaginal walls [34,35,36].…”

Section: Treatment Options For Vulvovaginal Atrophymentioning

confidence: 99%

Vaginal Health in Menopausal Women

et al. 2019

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The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of genitourinary syndrome (GSM). This condition has a high prevalence among post-menopausal women and negatively affects a woman’s quality of life. Epidemiology, signs, symptoms, diagnostic criteria of VVA and target treatments for restoring vaginal health are discussed in light of the most recent literature. Issues related to this condition in menopausal women are under-diagnosed, lack objective diagnostic criteria, and consequently under-treated. Over the years, many treatments have been developed but their long-term effectiveness and safety have yet to be clearly defined. Patients are often dissatisfied and stop treatment, suggesting the need for a more personalized and tailored approach to achieve better compliance and thereby effectiveness. The aim of this paper is to provide an overview of the most recent literature on VVA in order to help the gynecologist in the management of this condition.

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Efficacy of vaginal therapies alternative to vaginal estrogens on sexual function and orgasm of menopausal women: A systematic review and meta-analysis of randomized controlled trials

Cited by 42 publications

References 61 publications

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

Sexual Health in Menopause

Vaginal Health in Menopausal Women

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