Hormonal Medications for Genitourinary Syndrome of Menopause

Abstract

Genitourinary syndrome of menopause is a common, under-reported, and undertreated chronic progressive condition requiring long-term treatment. Hypoestrogenism in the urogenital tissues is associated with bothersome dyspareunia, vulvovaginal symptoms, overactive bladder, and frequent urinary tract infections. Vaginal hormone therapies, including vaginal estrogen and intravaginal dehydroepiandrostenedione, are safe and effective and improve symptoms and clinical findings. Systemic hormone therapy treats vulvovaginal atrophy less effectively than vaginal hormone therapies with increased stress and urge urinary incontinence. Oral ospemifene effectively treats vaginal dryness and dyspareunia. Clinicians need to ask about symptoms of genitourinary syndrome of menopause, confirm the diagnosis, and suggest appropriate treatment options.

The Utility of CO2 Laser Treatment of Pelvic Symptoms in Women with Previous Perineal Trauma during Delivery

“…Pelvic floor exercises, such as Kegel exercises, may help improve pelvic floor tone and alleviate some symptoms. Therefore, local estrogens in the form of creams, pessaries, tablets, and the estradiol-releasing ring represent the first-line therapy [16]. To offer clinicians and women an improved non-drug option for managing symptoms connected to VVA, the microablative fractional CO 2 laser has emerged and has been utilized in recent years [17,18].…”