Hormonal Approach for Postmenopausal Vulvovaginal Atrophy

Abstract

Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.

Effects of Preoperative Preparation on the Vaginal Mucosa in Women with Genital Prolapse Associated with Genitourinary Menopausal Syndrome

“…So in our study, a critical decrease in lactobacilli in the vagina in women with genital prolapse in postmenopausal women was demonstrated. Alkalinization of vaginal contents and insufficiency of the lactobacilli pool increase the likelihood of inflammatory diseases of the genital tract and urinary system, mainly with ascending infection.It is known that in postmenopausal age, against the background of hypoestrogenism, the number of lacto-and bifidobacteria in the vagina decreases, while the composition of the microflora becomes scarce with the dominance of obligate anaerobic bacteria[12,13]. It is possible that just such features of the bacteriological status of the vaginal epithelium of the operating area can be the cause of infectious and inflammatory complications after surgical treatment of HP.…”