Pharmacotherapy for the treatment of vaginal atrophy

Donders, Gilbert; Ruban, Kateryna; Bellen, Gert; Grincevičienė, Švitrigailė

doi:10.1080/14656566.2019.1574752

Cited by 44 publications

(41 citation statements)

References 119 publications

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“…Атрофія цервікального епітелію -фізіологічний процес, наслідок дефіциту естрогенів, необхідних для дозрівання плоского епітелію. Атрофія цервікального епітелію може мати місце не лише у постменопаузальних жінок, а й у жінок після пологів, тривалих користувачок низькодозованих комбінованих гормональних контрацептивів, жінок із гормональними порушеннями, медикаментозною менопаузою [43,44].…”

Section: атрофія цервікального епітеліюunclassified

The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them

Бурка

Lygyrda

Kutsovol³

et al. 2021

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Cervical cancer (CC) screening is a major component of secondary prevention of CC and involves screening all women at risk of developing this disease, most of whom are asymptomatic. Cytology remains an important component of CC screening in the era of primary screening by genotyping the human papillomavirus. Papanikolaou staining is the method of choice for CC screening. This review highlights the causes of false negative results for various methods of Pap tests and how they can be prevented. A detailed analysis of conditions accompanied by a high probability of false positive abnormal results of the Pap test, an explanation of the pathophysiological basis of this phenomenon, clinical and cytological criteria for differential diagnosis is also presented.Pap test is a screening test. The aim of the cytological examination in CC screening is to assign the patient to a group with absent neoplastic changes in the cervical epithelium, a group with neoplastic changes in the cervical epithelium present, or a group when it is impossible to make an accurate differential diagnosis between benign reactive changes and neoplasia. The Bethesda Cytology Reporting System is used to unify and standardize these categories in most countries of the world. Benign conditions are a common cause of false positive reports of cellular atypia on cervical screening, as evidenced by a large number of studies. This fact should be taken into account both in the interpretation of the results and, if possible, in the planning of cervical screening. The most common conditions that are accompanied by reactive changes in the cervical epithelium, which can be incorrectly assessed as atypia, are: reactive and reparative inflammatory changes, atrophy, metaplasia, reactive changes caused by intrauterine devices. In this regard, when working with the cytological component of cervical screening, it is important for the clinician to understand the basic principles of assessing the cervical epithelium, which will allow using the descriptive part of the report to determine tactics if a false negative or false positive screening result is suspected.Thus, understanding the impact of common benign conditions on the cervical epithelium makes it possible to rationally plan cytological cervical screening and correctly interpret its results in order to achieve the best clinical results that are not limited to the detection of precancerous conditions.

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Section: атрофія цервікального епітеліюunclassified

The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them

Бурка

Lygyrda

Kutsovol³

et al. 2021

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“…It merely reflects the expert opinion of the authors by analyzing the amount of available evidence (1990–2019) in this complex field of research. Therapeutic strategies to effectively manage sexual symptoms associated with VVA/GSM have been reviewed extensively elsewhere (7–12) and, in here, they will be discussed briefly to serve the scope of preventing severe VVA/GSM in elderly women.…”

Section: Introductionmentioning

confidence: 99%

Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women

et al. 2019

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Vaginal health is an essential component of active and healthy aging in women at midlife and beyond. As a consequence of hormonal deprivation and senescence, the anatomy and function of urogenital tissues are significantly affected and vulvovaginal atrophy (VVA) may occur. In a high proportion of postmenopausal women, progressive and chronic VVA symptoms have a strong impact on sexual function and quality of life. The new definition of genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections). Many variables (age, sexual activity and partnership status) influence the clinical impact VVA/GSM symptoms and attitudes of elderly women to consult for receiving effective treatments. Psychosocial factors play a critical role in sexual functioning, but the integrity of the urogenital system is as well important affecting many domains of postmenopausal women's health, including sexual function. Several international surveys have extensively documented the need to improve VVA/GSM management because of the strong impact on women's daily life and on couple's intimacy. Health care providers (HCPs) need to be proactive in the early recognition of VVA/GSM in order to preserve urogenital and sexual longevity, by using hormonal and non-hormonal strategies. The clinical diagnosis is based on genital examination to identify objective signs and on the use of subjective scales to rate most bothersome symptoms (MBS), especially vaginal dryness. Recent studies point to the importance of addressing VVA/GSM as a potential early marker of poor general health in analogy with vasomotor symptoms. Therefore, a standard of VVA/GSM care in elderly women is desirable to enhance physical, emotional and mental well-being.

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“…Estrogen replacement is the ideal treatment for GSM and maintains the integrity of the urogenital system. Vaginal administration is the most recommended since it is the best tolerated because, even at low doses, it is effective in restoring vaginal trophism, with little systemic absorption, is safe, and provides rapid improvement in symptoms [8] [9] [10].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life before and after the Use of Vaginal Estriol in Postmenopausal Women with Lower Urinary Tract Symptoms

Freitas¹,

Faria²

2020

OJOG

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Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antônio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King's Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.

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Pharmacotherapy for the treatment of vaginal atrophy

Cited by 44 publications

References 119 publications

The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them

The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them

Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women

Quality of Life before and after the Use of Vaginal Estriol in Postmenopausal Women with Lower Urinary Tract Symptoms

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