Genitourinary syndrome of menopause – is the problem solved? 
State of the art 2018

Szymański, Jacek Krzysztof; Zaręba, Kornelia; Jakiel, Grzegorz; Słabuszewska-Jóźwiak, Aneta

doi:10.5114/pm.2018.81741

Cited by 4 publications

(2 citation statements)

References 58 publications

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“…GSM is a common health issue affecting up to 70% of postmenopausal women [10]. Vaginally administered estrogen is the most studied intervention and the mainline of treatment to antagonize urogenital aging and improve the QOL in this population of patients [11]. Nonetheless, the safety pro le of estrogen is controversial in the long run due to the fear of increasing the risk of certain types of cancer and thromboembolic events; we need to mention that this quarrel is due to limited data [12].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

Farahat

Salamah

Mahmoud

et al. 2023

Preprint

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Background Genitourinary syndrome of menopause (GSM) is a common disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study aims to evaluate the efficacy and safety of oxytocin gel versus placebo gel in postmenopausal women with GSM. Methods A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from Web of Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled Trials databases on January 18, 2023. We used the risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes; both presented with the corresponding 95% confidence interval (CI). Results Seven studies with 631 patients were included. Regarding the maturation index, there was a statistically insignificant increase in the oxytocin arm (MD= 12.34, 95% CI (-12.52-37.19), P= 0.33). Vaginal atrophy showed a statistically significant reduction in the oxytocin group (RR= 0.32, 95% CI (0.23-0.10), P< 0.00001). For dyspareunia, vaginal pH as well as histological evaluation of vaginal atrophy, there was a statistically insignificant difference between the two groups (RR= 1.02, 95% CI (0.82 -1.27), P= 0.84), (MD= -0.74, 95% CI (-1.58-0.10), P= 0.08) and (MD= -0.38, 95% CI (-0.82-0.06), P= 0.09) respectively. There was no significant difference in the safety profile between the two groups as measured by endometrial thickness (MD= 0.00, 95% CI (-0.23-0.23), P= 0.99). Conclusions Although oxytocin has been proposed as a viable alternative to estrogen in the treatment of GSM, our findings show the opposite. Larger, high-quality RCTs are needed to confirm or refute our results. PROSPERO number CRD42022334357.

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Section: Introductionmentioning

confidence: 99%

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

Farahat

Salamah

Mahmoud

et al. 2023

Preprint

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“…The incidence of GSM increases with living longer after menopause, and the symptoms tend to worsen over time. Although the symptoms are unlikely to resolve without treatment, only around 20% of patients seek medical attention [5]. However, the number of postmenopausal women seeking treatment for GSM is rising with increasing requirements for a better quality of life.…”

Section: Introductionmentioning

confidence: 99%

The Fractional CO₂ Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study

Zhou

et al. 2020

Lasers Surg Med

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Background and Objectives: Genitourinary syndrome of menopause (GSM) is a common condition affecting of most postmenopausal women, which greatly impacks the quality of life,and need to treat. This prospective multicenter cohort study aimed to compare the efficacy and safety of the fractional carbon dioxide (CO 2 ) laser with that of topical estrogen for vaginal treatment and relieving symptoms of genitourinary syndrome of menopause (GSM). Study Design/Materials and Methods: This study included 162 postmenopausal patients who received vaginal laser or topical Estriol cream therapy between January 2017 and May 2019 at eight study centers in China. The degree of GSM-related symptoms (vaginal burning, dryness, and dyspareunia) was evaluated using the Vaginal Health Index score (VHIS) and Visual Analog Scale (VAS) at baseline, 1, 3, 6, and 12 months posttreatment. The primary endpoint was the improvement in vaginal burning, dryness, and dyspareunia at 6 months after treatment. Multivariate logistic regression was used to compare the rate of improvement in the two groups. Results: At baseline, the laser and control groups showed no significant difference in the mean age, time after menopause, and the VHIS (all P > 0.05). In the laser group, compared with baseline, significant differences were seen in the VHIS after the first or second treatment session and at 1, 3, 6, and 12 months posttreatment (P < 0.01). In the control group, compared with baseline, the VHIS showed significant differences after 1, 3, and 6 months of treatment (P < 0.05). However, there was no significant difference after 3 and 6 months of follow-up between the two groups (P > 0.05). The VHIS scores were significantly higher after 1 month (16.63 ± 2.79 vs. 15.57 ± 2.43) and 12 months (15.72 ± 2.59 vs. 12.12 ± 4.08) of treatment in both the groups (P < 0.05). At 6 months after treatment, both groups showed improvement in vaginal burning, vaginal dryness, and dyspareunia (P > 0.05). The VAS findings at 6 months posttreatment were significantly different when compared with the pretreatment findings (P < 0.001). There were no significant adverse effects in the two groups. Conclusions: Fractional CO 2 laser vaginal treatment could be a safe and effective option for treating symptoms of GSM, including vaginal burning, dryness, and dyspareunia. The improvement in symptoms was comparable

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The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis

Farahat,

Salamah,

Mahmoud

et al. 2023

BMC Women's Health

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Background Genitourinary syndrome of menopause (GSM) is a common and disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study aims to evaluate the efficacy and safety of oxytocin gel versus placebo gel in postmenopausal women with GSM. Methods A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from Web of Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled Trials databases on January 18, 2023. Keywords such as “oxytocin,“ “intravaginal,“ “vaginal,“ “atrophic,“ and “atrophy” were used. We used Review Manager (RevMan) version 5.4 in our analysis. We used the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes; both were presented with the corresponding 95% confidence interval (CI) and were calculated with the Mantel-Haenszel or inverse variance statistical method. Cochrane’s Q test and the I2 statistic were used as measures of statistical inconsistency and heterogeneity. The Cochrane Risk of Bias Tool for RCTs was used for the quality assessment of the included studies. Results Seven studies with 631 patients were included. Regarding the maturation index, there was a statistically insignificant increase in the oxytocin arm (MD = 12.34, 95% CI (-12.52-37.19), P = 0.33). Clinically assessed vaginal atrophy showed a statistically significant reduction in the oxytocin group (RR = 0.32, 95% CI (0.23 − 0.10), P < 0.00001). For dyspareunia, vaginal pH, and histological evaluation of vaginal atrophy, there was a statistically insignificant difference between the two groups (RR = 1.02, 95% CI (0.82–1.27), P = 0.84), (MD = -0.74, 95% CI (-1.58-0.10), P = 0.08), and (MD = -0.38, 95% CI (-0.82-0.06), P = 0.09), respectively. There was no significant difference in the safety profile between the two groups as measured by endometrial thickness (MD = 0.00, 95% CI (-0.23-0.23), P = 0.99). Conclusions Although oxytocin has been proposed as a viable alternative to estrogen in the treatment of GSM, our findings show the opposite. Larger, high-quality RCTs are needed to confirm or refute our results. Trial registration PROSPERO registration number CRD42022334357.

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Genitourinary syndrome of menopause – is the problem solved? State of the art 2018

Cited by 4 publications

References 58 publications

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

The Fractional CO₂ Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study

The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis

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Genitourinary syndrome of menopause – is the problem solved? State of the art 2018

Cited by 4 publications

References 58 publications

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study

The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis

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The Fractional CO₂ Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study