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Lambrinoudaki I, Mili N, Augoulea A, Armeni E, Vlahos N, Mikos T, Grimbizis G, Rodolakis A, Athanasiou S. The LADY study: epidemiological characteristics of prevalent and new genitourinary syndrome of menopause cases in Greece. Climacteric 2024; 27:289-295. [PMID: 38415685 DOI: 10.1080/13697137.2024.2314504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE The genitourinary syndrome of menopause (GSM) is often underdiagnosed and undertreated despite its significant impact on postmenopausal quality of life. We assessed the prevalence of GSM and associated symptoms in Greek perimenopausal/postmenopausal women attending gynecology clinics. METHODS Four hundred and fifty women, aged 40-70 years (93.1% postmenopausal), attending three gynecology clinics at university hospitals completed a validated questionnaire and underwent pelvic examination. RESULTS GSM was diagnosed in 87.6% of the women at the study visit, whereas only 16% of the overall sample had been previously diagnosed with the condition. Vaginal dryness (72.7%), vulvar burning sensation or itching (58.0%) and dyspareunia (52.7%) were the most prevalent symptoms. Pelvic signs consisted of vaginal dryness (89.1%), loss of vaginal rugae (80.6%) and vulvovaginal pallor (86.9%). However, only 31.3% of the participants had discussed genitourinary symptoms with their health-care professionals (HCPs). Regarding management, only 11.1% of women had prior experience with any form of therapy, and currently only 8.7% were receiving treatment. CONCLUSION GSM is highly prevalent in this Greek perimenopausal/postmenopausal population. Nevertheless, the majority of women remain undiagnosed and untreated. Education for both women and HCPs regarding GSM will lead to improved diagnosis and better management of this syndrome.
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Affiliation(s)
- I Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - N Mili
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - A Augoulea
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - E Armeni
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - N Vlahos
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - T Mikos
- 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - G Grimbizis
- 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - A Rodolakis
- 1st Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - S Athanasiou
- 1st Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
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Wongapai P, Jirasawas T, Vichinsartvichai P. Thai postmenopausal woman's view in genitourinary syndrome of menopause. Post Reprod Health 2024:20533691241254701. [PMID: 38755592 DOI: 10.1177/20533691241254701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To determine the prevalence of genitourinary syndrome of menopause (GSM) and their awareness, attitudes, and perception of this issue. STUDY DESIGN Using a specifically designed questionnaire, interviews were performed on 500 Thai postmenopausal women who attended at Vajira Hospital, Bangkok, Thailand, from August 2021 to April 2022. RESULTS The mean age of the 500 participants was 60.39 ± 8.12 years. The prevalence of GSM was 47.2%. The common symptoms affected by GSM were vaginal dryness (38.5%), urinary urgency (24.6%), dyspareunia (13.6%), vaginal irritation (10.2%), vaginal burning (7.2%), and dysuria (5.9%). One-half of the women were uncomfortable talking about GSM. Three-quarters who did not reveal GSM symptoms believed that the problem was a part of aging. Only 20.3% of women who suffer from symptoms consulted a health care provider (HCP). Of the women who had been prescribed treatment, 84.6% of these women reported better quality of life. CONCLUSIONS GSM is a meaningful decrement in quality of life. Most Thai postmenopausal women who had symptoms believed that the problem was the aging process. Awareness of GSM and available treatment would be a further benefit.
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Affiliation(s)
- Pattra Wongapai
- Depatment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Titima Jirasawas
- Depatment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Patsama Vichinsartvichai
- Depatment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Ulhe SC, Acharya N, Vats A, Singh A. Study of Vulvovaginal Atrophy and Genitourinary Syndrome of Menopause and Its Impact on the Quality of Life of Postmenopausal Women in Central India. Cureus 2024; 16:e54802. [PMID: 38529421 PMCID: PMC10961929 DOI: 10.7759/cureus.54802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
Background Urogenital health is a necessary part of health for all women, especially in the postmenopausal age group. We suspected that the increased incidence of vulvovaginal atrophy (VVA) had some or other effects on the quality of life of older women. So, we aimed to study VVA/genitourinary syndrome of menopause (GSM) and its impact on the quality of life of postmenopausal women in Central India. Despite its significant prevalence and detrimental impact on women's health, VVA/GSM is underdiagnosed and undertreated. In view of the feminization of aging, VVA management is becoming increasingly crucial. This study contributes to postmenopausal women's understanding that keeping their urogenital and sexual longevity is a critical step toward healthy living and gender equality. Given its relationship with urogynecological conditions, this study will help to evaluate both subjectively and objectively the incidence of symptoms related to VVA and its effects on the quality of life of postmenopausal women. This will eventually help to understand the need to address this issue while making postmenopausal women health-related policies. Potential remedies to overcome the obstacles currently preventing patient-HCP interactions addressing sexual health include providing communication tools to facilitate the "uncomfortable" conversation, educating women, and providing enough training for healthcare professionals. Methods The current study was conducted at a rural tertiary healthcare center in Central India and is a cross-sectional study. The study population taken into consideration were all the postmenopausal women between the age group 45 and 75 years with at least one vulvovaginal symptom attending the Outpatient Department (OPD). The total study sample size was 100 women. Further study was conducted by interview method using a questionnaire by the principal investigator. Data was gathered with the help of a pretested questionnaire in the patient's language. Symptoms related to GSM were studied by the vaginal symptom Bothersomeness Scale. Further, a gynecological clinical examination for the confirmation of VVA was carried out, which included a gynecological physical examination. The Vaginal Health Index (VHI) was calculated for each female using the score scale. Assessment of the quality of life of postmenopausal females using the Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire was performed. Results The majority of females (34%) who presented with the symptoms were in the category of 55-60 years followed by 22% in the age group of 61-65 years. The most common symptoms experienced by females were vaginal dryness (77%) followed by vaginal discharge (74%). Our study confirmed that 79% of the total females included in the study have a VHI score of less than 15, i.e., they suffer from VVA, thus presenting our incidence at 79%. Conclusion According to the surveys discussed in this research, a significant portion of postmenopausal women have symptoms linked to VVA that have a negative impact on their quality of life, including their sexual relationships and self-esteem.
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Affiliation(s)
- Samiksha C Ulhe
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aarav Vats
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Awantika Singh
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Dinish US, Logan S, Balasundaram G, Xinhui VT, Vinod Ram K, Ruochong Z, Renzhe B, Silvani S, Hua Cheng K, Xia X, Giap Hean G, Choolani M, Olivo M. Diffuse reflectance spectroscopy and imaging for non-invasive objective assessment of genitourinary syndrome of menopause: a pilot study. Sci Rep 2024; 14:1085. [PMID: 38212347 PMCID: PMC10784538 DOI: 10.1038/s41598-023-49655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
The genitourinary symptom of menopause (GSM) affects up to 65% of women, resulting in symptoms such as vulvovaginal dryness, discomfort, and dysuria, which significantly impacts quality of life. The current assessment methods rely on subjective questionnaires that can be influenced by individual differences, as well as invasive measurements that are time-consuming and not easily accessible. In this study, we explore the potential of a non-invasive and objective assessment tool called diffuse reflectance spectroscopy and imaging (DRSI) to evaluate tissue chromophores, including water, lipid, oxyhemoglobin, and deoxyhemoglobin. These measurements provide information about moisture content, lipid levels, oxygen saturation, and blood fraction, which can serve as surrogate markers for genital estrogen levels. Our findings reveal distinct differences in these chromophores among pre, peri, and postmenopausal subjects. By using lipid and blood fraction tissue chromophores in a K-Nearest Neighbour classifier model, we achieved a prediction accuracy of 65% compared to vaginal maturation index (VMI) that is clinically used to assess estrogen-related hormonal changes. When age was included as the third feature, the accuracy increased to 78%. We believe that by refining the study protocol and configuring the fiber probe to examine tissue chromophores both in the superficial vulva skin for epidermal water content and the deeper layers, DRSI has the potential to provide objective diagnosis and aid in monitoring the treatment outcome of GSM.
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Affiliation(s)
- U S Dinish
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore.
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore.
| | - Susan Logan
- Department of Obstetrics and Gynaecology, NUS Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore.
- Department of Obstetrics and Gynaecology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore.
- Department of Sexual and Reproductive Health, NHS Grampian, Aberdeen, Scotland, UK.
| | - Ghayathri Balasundaram
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore
| | - Valerie Teo Xinhui
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore
| | - Keertana Vinod Ram
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore
| | - Zhang Ruochong
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore
| | - Bi Renzhe
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore
| | - Steffie Silvani
- Department of Obstetrics and Gynaecology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Kee Hua Cheng
- Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Xu Xia
- Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Goh Giap Hean
- Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, NUS Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Malini Olivo
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Innovis #08-03, Singapore, 138634, Republic of Singapore.
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology and Research (A*STAR), 31 Biopolis Way, #07-01 Nanos, Singapore, 138669, Republic of Singapore.
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Hou SY, Chiu CJ, Shea JL, Wang CL, Tang HH, Kuo PC, Yang YC, Wu CH. Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms. Sleep Med 2024; 113:172-179. [PMID: 38039943 DOI: 10.1016/j.sleep.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Midlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms. METHODS A total of 87 women aged 45-60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms. RESULTS A sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = -0.26 and β = -0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms. CONCLUSIONS Premenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.
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Affiliation(s)
- Szu-Yu Hou
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Jeanne Laraine Shea
- Department of Anthropology, University of Vermont, Burlington, VT, 05405, USA
| | - Chih-Liang Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Han Tang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Ching Kuo
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chieh Yang
- Yang's Clinic of Obstetrics and Gynecology, Tainan, Taiwan
| | - Chih-Hsing Wu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Davis SR, Pinkerton J, Santoro N, Simoncini T. Menopause-Biology, consequences, supportive care, and therapeutic options. Cell 2023; 186:4038-4058. [PMID: 37678251 DOI: 10.1016/j.cell.2023.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023]
Abstract
Menopause is the cessation of ovarian function, with loss of reproductive hormone production and irreversible loss of fertility. It is a natural part of reproductive aging. The physiology of the menopause is complex and incompletely understood. Globally, menopause occurs around the age of 49 years, with geographic and ethnic variation. The hormonal changes of the menopause transition may result in both symptoms and long-term systemic effects, predominantly adverse effects on cardiometabolic and musculoskeletal health. The most effective treatment for bothersome menopausal symptoms is evidence-based, menopausal hormone therapy (MHT), which reduces bone loss and may have cardiometabolic benefits. Evidence-based non-hormonal interventions are also available for symptom relief. Treatment should be individualized with shared decision-making. Most MHT regimens are not regulator approved for perimenopausal women. Studies that include perimenopausal women are needed to determine the efficacy and safety of treatment options. Further research is crucial to improve menopause care, along with research to guide policy and clinical practice.
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Affiliation(s)
- Susan R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; Department of Endocrinology and Diabetes, Alfred Health, Commercial Rd., Melbourne, VIC 3004, Australia.
| | - JoAnn Pinkerton
- Department of Obstetrics and Gynecology, Division of Midlife Health, The University of Virginia Health System, Charlottesville, VA, USA
| | | | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Chao HT, Chang PC, Lin YK, Huang WC, Wu CC, Chang LI, Liao YM. Longitudinal Effects of a Combined Program of Pelvic Floor Muscle Training and Yoga on Genitourinary Symptoms in Asian Women of Older Age: A Randomized Experimental Study. Geriatr Nurs 2022; 46:27-38. [PMID: 35597057 DOI: 10.1016/j.gerinurse.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/04/2022]
Abstract
This parallel-two-group randomized experimental study including a supervised group and an unsupervised group examined the longitudinal effects of pelvic floor muscle training (PFMT) combined with yoga on genitourinary symptoms and the health-related quality of life (HRQOL), and compared practice adherence rates of the two groups. A sample of women experiencing ≥1 genitourinary symptom(s) were recruited and assigned to a supervised group or an unsupervised group. The supervised group attended supervised group practice sessions and performed at-home practice of PFMT and yoga. The unsupervised group performed at-home practice of PFMT and yoga. Information was collected at five time points (n = 91). Generalized estimating equation procedures were used to examine the intervention effects. An independent t-test was conducted to compare the practice adherence rates. Both groups' genitourinary symptoms and HRQOL significantly improved over time. The supervised group displayed greater improvements in genitourinary symptoms and HRQOL and better adherence than did the unsupervised group.
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Affiliation(s)
- Hsiang-Tai Chao
- Obstetrics and Gynecology Department, Taipei Veterans General Hospital, 201 Shi-Pai Road, Section 2, Taipei City 11217, Taiwan, Republic of China (R.O.C.); College of Medicine, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Taipei City 112, Taiwan, Republic of China (R.O.C.)
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Xing Street, Xinyi District, Taipei City 110, Taiwan, Republic of China (R.O.C.)
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, 250 Wenhua 1st Road, Guishan, Taoyuan 333, Taiwan, Republic of China (R.O.C.)
| | - Wen-Chen Huang
- Department of Obstetrics and Gynecology, Cathy General Hospital, 280 Ren-Ai Road, Section 4, Taipei City 106, Taiwan, Republic of China (R.O.C.); Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing Street, Xinyi District, Taipei City 110, Taiwan, Republic of China (R.O.C.)
| | - Chien-Chih Wu
- Department of Urology, Taipei Medical University Hospital, 252 Wu-Xing Street, Xinyi District, Taipei City 110, Taiwan, Republic of China (R.O.C.); Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing Street, Xinyi District, Taipei City 110, Taiwan, Republic of China (R.O.C.)
| | - Lu-I Chang
- Department of Nursing, College of Medicine, Tzu Chi University, 701 Zhong-Yang Road, Section 3, Hualien City 97004, Taiwan, Republic of China (R.O.C.)
| | - Yuan-Mei Liao
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Taipei City 112, Taiwan, Republic of China (R.O.C.).
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Logan S, Thu WPP, Ho K, Cauley JA, Kramer MS, Yong EL. Sexual inactivity and sexual dysfunction in midlife Singaporean women: A prospective cross-sectional study of prevalence and risk factors. Maturitas 2021; 152:1-9. [PMID: 34674802 DOI: 10.1016/j.maturitas.2021.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To examine factors relating to both sexual inactivity and sexual dysfunction in midlife Singaporean women. STUDY DESIGN Sociodemographic, medical/lifestyle factors, physical activity, BMI, handgrip strength (HGS) and physical performance data collected from healthy Chinese, Indian, and Malay women, aged 45-69 years, attending gynaecology clinics. MAIN OUTCOME MEASURES Sexual inactivity and sexual dysfunction (defined as total score ≤ 26.55) assessed using the Female Sexual Function Index (FSFI). RESULTS 1048 women completed the FSFI. Mean (±SD) age was 56.2 (±6.2). Sexual inactivity was reported by 43.2% and was positively associated with older age [55-64 years (aOR 2.0, 95% CI 1.3-3.0) and ≥65 years (aOR 2.5, 95% CI 1.2-5.1)], younger menarche (aOR 1.8, 95% CI 1.3-2.5), lowest education (aOR 2.1, 95% CI 1.2-3.6), lowest income (aOR 1.8, 95% CI 1.1-2.8), unmarried (aOR 4.0, 95% CI 2.6-6.4), nulliparity (aOR 1.9, 95% CI 1.1-3.4), and BMI <18.5 kg/m2 (aOR 2.7, 95% CI 1.3-5.6). Among the sexually active, sexual dysfunction was identified in 70.3%. Sexual dysfunction was positively associated with menopause ≥10 years (aOR 2.4, 95% CI 1.1-5.0), nulliparity (aOR 3.0, 95% CI 1.1-9.8), moderate/severe vaginal dryness (aOR 13.8, 95% CI 4.8-38.7) and HGS <18 kg (aOR 1.9, 95% CI 1.1-3.2) and negatively associated with use of menopausal hormone therapy (aOR 0.3, 95% CI 0.1-0.6). CONCLUSION This, the largest Singaporean sexual function study, is the first to include physical performance in a healthy population. Most were sexually active but reported dysfunction. Novel associations included underweight BMI with sexual inactivity and weaker HGS and Malay ethnicity with greater and less sexual dysfunction, respectively.
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Affiliation(s)
- Susan Logan
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, 119228, Singapore; NUS Yong Loo Lin School of Medicine, National University of Singapore, 19228, Singapore.
| | - Win Pa Pa Thu
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, 119228, Singapore
| | - Kylie Ho
- NUS Yong Loo Lin School of Medicine, National University of Singapore, 19228, Singapore
| | - Jane A Cauley
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, United States
| | - Michael S Kramer
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, 119228, Singapore; Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec H3G 1Y6, Canada
| | - Eu-Leong Yong
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, 119228, Singapore; NUS Yong Loo Lin School of Medicine, National University of Singapore, 19228, Singapore.
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Voedisch AJ, Dunsmoor-Su R, Kasirsky J. Menopause: A Global Perspective and Clinical Guide for Practice. Clin Obstet Gynecol 2021; 64:528-554. [PMID: 34323232 DOI: 10.1097/grf.0000000000000639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perimenopause and menopause are a time of great transition for women-physically, mentally, and emotionally. Symptoms of the menopause transition and beyond impact women worldwide. Unfortunately, physician knowledge and comfort with addressing menopausal concerns vary greatly, limiting the support physicians provide to women in need. This review aims to increase physician understanding of the epidemiology, physiology, symptomology, and treatment options available for perimenopausal and menopausal women. Our goal is to empower physicians to educate and treat their patients to reduce the negative impact of perimenopausal changes and enhance overall well-being for women.
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Affiliation(s)
- Amy J Voedisch
- Department of Obstetrics and Gynecology, Division of Family Planning, Stanford University Medical Center, Stanford, California
| | | | - Jennifer Kasirsky
- Department of Obstetrics and Gynecology, Mediclinic Parkview Hospital, Dubai, UAE
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Mili N, Paschou SA, Armeni A, Georgopoulos N, Goulis DG, Lambrinoudaki I. Genitourinary syndrome of menopause: a systematic review on prevalence and treatment. Menopause 2021; 28:706-716. [PMID: 33739315 DOI: 10.1097/gme.0000000000001752] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Genitourinary syndrome of menopause (GSM) consists of genitourinary tract symptoms that occur due to physical changes caused by estrogen concentrations decline after menopause. Unlike menopausal symptoms, which subside with time, GSM symptoms persist throughout a woman's life. OBJECTIVE This article aimed to systematically review the literature to investigate the prevalence of GSM and its treatment. EVIDENCE REVIEW The search was conducted in the electronic databases PubMed, CENTRAL, and EMBASE until October 2020. Eligible for the systematic review were studies and surveys conducted via questionnaires or medical interviews evaluating the existence of GSM symptoms with or without gynecological examination in postmenopausal women or women >40 years of age. FINDINGS After the application of predefined inclusion/exclusion criteria, 27 studies were included in the systematic review. The prevalence of GSM-related symptoms, such as vaginal dryness, irritation, itching, and dyspareunia, ranged from 13% to 87%. The use of GSM-specific treatment varied from 13% to 78%. Over-the-counter lubricants and moisturizers were the most popular therapeutic options (24.0%-85.5%), followed by low-dose vaginal estrogens (4.8%-35.0%). Vaginal health is not frequently discussed during doctor visits and awareness about the condition and the number of treatment options is low. Women are concerned about the long-term safety and side effects of hormonal treatment. The majority of women who suffer from genitourinary symptoms are dissatisfied by the treatment they have used. CONCLUSIONS AND RELEVANCE GSM is a highly prevalent condition among women. Nevertheless, women are frequently not aware of its cause and its treatment options. The findings of this review underline the need for education of patients and healthcare professionals regarding GSM diagnosis and treatment options.
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Affiliation(s)
- Nikoletta Mili
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Armeni
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | - Neoklis Georgopoulos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Geng L, Huang W, Jiang S, Zheng Y, Zhou Y, Zhou Y, Hu J, Li P, Tao M. Effect of Menopausal Hormone Therapy on the Vaginal Microbiota and Genitourinary Syndrome of Menopause in Chinese Menopausal Women. Front Microbiol 2020; 11:590877. [PMID: 33329470 PMCID: PMC7718012 DOI: 10.3389/fmicb.2020.590877] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Genitourinary syndrome of menopause (GSM) is a chronic and progressive condition with a series of vulvovaginal, sexual, and lower urinary tract discomforts, mainly due to hypoestrogenism. Menopausal hormone therapy (MHT) has generally been considered as the most effective treatment for GSM. In addition, vaginal microbiota is of particular significance to gynecological and reproductive illnesses and potentially has some intimate connections with GSM. Consequently, we sought to evaluate how MHT impacts the composition and structure of vaginal microbiota while alleviating GSM in Chinese menopausal women aged 45-65 years, which has not been investigated previously. 16S rRNA gene sequencing was performed to analyze microbial diversity and composition using vaginal swabs obtained from 100 menopausal women, classified as MHT women who have been taking tibolone regularly (n = 50) and non-treated women who never received any treatment (n = 50). Vaginal Health Index Score (VHIS) and GSM symptoms inquiry were also performed. We found that the vaginal microbial diversity decreased and that the abundance of Lactobacillus increased to be the dominant proportion significantly in the MHT group, in considerable contrast to vaginal microbiota of the non-treated group, which significantly comprised several anaerobic bacteria, namely, Gardnerella, Prevotella, Escherichia-Shigella, Streptococcus, Atopobium, Aerococcus, Anaerotruncus, and Anaerococcus. In this study, women without any MHT had significantly more severe GSM symptoms than those receiving tibolone, especially with regard to vulvovaginal dryness and burning, as well as decreased libido (P < 0.01). However, there was no significant difference in the severity of urological symptoms between the groups (P > 0.05). Furthermore, Lactobacillus was demonstrated to be associated with VHIS positively (r = 0.626, P < 0.001) and with GSM negatively (r = -0.347, P < 0.001). We also identified Chlamydia (r = 0.277, P < 0.01) and Streptococcus (r = 0.270, P < 0.01) as having a prominent association with more serious GSM symptoms. Our study provided an elucidation that MHT could notably alleviate GSM and conspicuously reshape the composition of the vaginal microbiota, which is of extreme importance to clinical practice for the management of GSM.
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Affiliation(s)
- Lulu Geng
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wenjun Huang
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Susu Jiang
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yanwei Zheng
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yibei Zhou
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yang Zhou
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiangshan Hu
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ping Li
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Minfang Tao
- Department of Gynaecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Wong JLJ, Thu WPP, Lim CW, Wang YL, Yong EL, Logan SJS. Health information needs of 1000 midlife Singaporean women. Climacteric 2020; 23:511-518. [DOI: 10.1080/13697137.2020.1767570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- J. L. J. Wong
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
| | - W. P. P. Thu
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
| | - C. W. Lim
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
| | - Y. L. Wang
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
| | - E. L. Yong
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
| | - S. J. S. Logan
- Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore, Republic of Singapore
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13
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Selvi I, Baydilli N, Yuksel D, Akinsal EC, Basar H. Reappraisal of the Definition Criteria for "Genitourinary Syndrome of Menopause," and its Effect on Quality of Life in Turkish Postmenopausal Women. Urology 2020; 144:83-91. [PMID: 32730817 DOI: 10.1016/j.urology.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To reappraise the definition of Genitourinary syndrome of menopause (GSM) and to evaluate the prevalence and effect of GSM on quality of life in Turkish postmenopausal women. METHODS A multicenter, cross-sectional, and observational study was designed. Four hundred three postmenopausal women between the ages of 43-75 who attended Urology and Gynecology clinics between November 2019 and April 2020 were included.They were divided into 2 groups: Group I (GSM, n:288, 71.5%) and Group II (non-GSM, n:115, 28.5%). Demographic data, presence and intensity of genitourinary symptoms were recorded. The impact of menopause and urinary incontinence on quality of life was evaluated with the Menopause-Specific Quality of Life Questionnaire and the King's Health Questionnaire. RESULTS The most common symptoms were vaginal dryness (66.2%), reduced lubrication (55.3%), and urgency (54.8%). Urinary incontinence was present in 39.2% of women. Worse quality of life in terms of psychosocial and sexual domains of the Menopause-Specific Quality of Life Questionnaire was significant in Group 1 (P < .001). Group 1 had significantly worse scores for all domains of the King's Health Questionnaire. Only the rate of patients with stress incontinence was higher in Group 1. However, the percentage of moderate and severe symptoms for all types of incontinence was higher in Group 1. Although the prevalence of GSM was 71.5% according to our definition, the percentage of patients previously visiting healthcare professionals for their symptoms was low (52.8%). CONCLUSION Our findings show that urologists and gynecologists should question both symptom groups of postmenopausal women, even if patients do not bring up genitourinary symptoms.
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Affiliation(s)
- Ismail Selvi
- Department of Urology, Karabük University Training and Research Hospital, Karabük, Turkey.
| | - Numan Baydilli
- Department of Urology, Erciyes University Medical School, Kayseri, Turkey
| | - Dilek Yuksel
- Department of Gynecological Oncology, Etlik Zübeyde Hanım Gynecology Training and Research Hospital, Ankara, Turkey
| | - Emre Can Akinsal
- Department of Urology, Erciyes University Medical School, Kayseri, Turkey
| | - Halil Basar
- Department of Urology, Health Science University Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Local treatment with a polycarbophil-based cream in postmenopausal women with genitourinary syndrome of menopause. Int Urogynecol J 2020; 32:317-322. [PMID: 32206846 PMCID: PMC7838131 DOI: 10.1007/s00192-020-04282-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/06/2020] [Indexed: 01/01/2023]
Abstract
Introduction and hypothesis Genitourinary syndrome of menopause (GSM) is a common problem associated with lower urinary tract and gynecological symptoms due to the decrease in estrogen production in postmenopausal women. Topical estrogen therapy is shown to improve these symptoms; nonetheless, there are limited data on the efficacy of nonhormonal moisturizers in these patients. Methods A prospective cohort study was conducted to compare the symptoms of GSM before and after treatment with a polycarbophil-based cream in 42 women. The quality of life (QoL) and sexual scores were obtained from the Thai version of the International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms (ICIQ-LUTS) along with uroflow measurements before and 4 and 12 weeks after treatment. Results Significant improvements in ICIQ-LUTSqol scores were observed after 4 weeks (9.38 ± 7.47 vs 6.76 ± 5.77; p = 0.017) and 12 weeks (10.03 ± 7.49 vs 5.97 ± 4.02; p = 0.002) when compared with the baseline values before treatment. The ICIQ-LUTS sexual scores were also improved after treatment at 4 weeks (2.29 ± 2.26 vs 0.88 ± 1.34; p < 0.001) and 12 weeks (2.13 ± 2.22 vs 0.42 ± 0.81; p < 0.001) compared with the baseline scores. No differences in ICIQ-LUTSqol and sexual scores were observed between the 4- and 12-week treatment groups. Conclusion The polycarbophil-based cream improved the overall LUTS and sexual symptoms in the patients with GSM, thus indicating that the nonhormonal polycarbophil-based cream may prove effective for the treatment for women with this condition.
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15
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Srisukho S, Pantasri T, Piyamongkol W, Phongnarisorn C, Morakote N. The experience of genitourinary syndrome of menopause (GSM) among Thai postmenopausal women: the non-reporting issue. Int Urogynecol J 2019; 30:1843-1847. [PMID: 31165220 DOI: 10.1007/s00192-019-03991-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Genitourinary syndrome of menopause (GSM) is common among postmenopausal women, but, in general, not all of the patients seek medical advice as this sensitive issue can cause them embarrassment. OBJECTIVES To explore the prevalence of GSM among Thai postmenopausal women and their disclosure of and attitude towards GSM. METHODS A questionnaire was used to obtain information on GSM from 499 Thai postmenopausal women who attended the Menopause Clinic at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand, from November 2015 to August 2016. RESULTS The mean age of the 499 participants was 57.8 ± 7.2 years. It was notable that 87.2% of them had had GSM, and the prevalence increased with age. The most common symptoms were nocturia (77.7%) and vaginal dryness (51.7%). Among the symptomatic patients, 63.0% conveyed their problem to other people, i.e., friends and family, while 52.9% of them never reported to health care providers. The most common reason for not talking about their GSM was the acceptance of it being part of the natural aging process. CONCLUSIONS GSM is common among Thai postmenopausal women. The prevalence of non-reporting is high and underreported.
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Affiliation(s)
- Sasivimol Srisukho
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tawiwan Pantasri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Wirawit Piyamongkol
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chailert Phongnarisorn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nuntana Morakote
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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La Rosa VL, Ciebiera M, Lin LT, Fan S, Butticè S, Sathyapalan T, Jędra R, Lordelo P, Favilli A. Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2019; 18:116-122. [PMID: 31488961 PMCID: PMC6719636 DOI: 10.5114/pm.2019.86836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/23/2019] [Indexed: 02/05/2023]
Abstract
The climacteric is considered a natural phase in a woman's aging process and is defined as the period starting from the decline in ovarian activity until after the end of ovarian function. Genitourinary syndrome of menopause (GSM) is commonly observed in menopausal women and is characterised by a collection of symptoms resulting from changes to the internal and external genitalia as well as the lower urinary tract. Several studies have demonstrated the close association between sexual dysfunction and symptoms related to GSM. Many medications, at different doses, have been studied over the years for the treatment of the symptoms of GSM. More specifically, ultralow-dose intravaginal oestriol and intravaginal dehydroepiandrosterone (DHEA) are reported to improve symptoms, signs, and quality of life of women with GSM, and they are safe owing to their specific local effect. While the dosage and the administration of intravaginal DHEA are well defined, the literature on intravaginal oestriol is less uniform: different doses and times of administration are proposed with different possible combinations with other non-pharmacological therapies, although a more standardised treatment may be necessary. The aim of this review is to summarise the available data about the effects of ultralow-concentration oestriol and intravaginal DHEA on the menopause-related symptoms, quality of life, and sexual function of women affected by GSM.
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Affiliation(s)
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynaecology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Li-Te Lin
- Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shangrong Fan
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Salvatore Butticè
- Department of Urology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Robert Jędra
- Second Department of Obstetrics and Gynaecology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Alessandro Favilli
- Section of Obstetrics and Gynaecology, Department of Surgical and Biomedical Sciences, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
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17
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Shea AK, Meschino D, Wolfman W. The effect of serotonin reuptake inhibitors on the vaginal epithelium in postmenopausal women. Climacteric 2019; 22:507-510. [DOI: 10.1080/13697137.2019.1604655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A. K. Shea
- Department of Obstetrics and Gynecology, St. Joseph’s Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - D. Meschino
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - W. Wolfman
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
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Chaikittisilpa S, Soimongkol K, Jaisamrarn U. Efficacy of oral estrogen plus testosterone gel to improve sexual function in postmenopausal women. Climacteric 2019; 22:460-465. [DOI: 10.1080/13697137.2019.1577378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Chaikittisilpa
- Menopause Research Unit, Reproductive Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - K. Soimongkol
- Reproductive Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - U. Jaisamrarn
- Menopause Research Unit, Reproductive Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Genitourinary syndrome of menopause - is the problem solved? State of the art 2018. MENOPAUSE REVIEW 2018; 17:168-174. [PMID: 30766464 PMCID: PMC6372854 DOI: 10.5114/pm.2018.81741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 12/27/2018] [Indexed: 12/19/2022]
Abstract
Vulvovaginal atrophy accompanied by lower urinary tract dysfunction related to low levels of estrogen and androgens is labeled as genitourinary syndrome of menopause (GSM). Although this condition affects most postmenopausal women worldwide, it seems to be underdiagnosed and undertreated. Women should be properly advised to choose an adequate treatment modality to improve their quality of life, sexual relationships and social activity. The aim of this article to is increase knowledge of GSM. The current treatment options, both hormonal and non-hormonal, are reviewed. Topical estrogen therapy still remains the gold standard, but the demand for individually tailored therapy is growing. New treatment modalities are continuously included in clinical practice. They should consider the whole personality of a woman as well as cultural and social factors. Further studies on GSM and on the effectiveness of various treatment options are necessary to achieve this purpose.
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Simon JA, Davis SR, Althof SE, Chedraui P, Clayton AH, Kingsberg SA, Nappi RE, Parish SJ, Wolfman W. Sexual well-being after menopause: An International Menopause Society White Paper. Climacteric 2018; 21:415-427. [DOI: 10.1080/13697137.2018.1482647] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- J. A. Simon
- IntimMedicine Specialists; George Washington University, Washington, DC, USA
| | - S. R. Davis
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - S. E. Althof
- Center for Marital and Sexual Health of South Florida, West Palm Beach, FL, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - P. Chedraui
- Instituto de Investigación e Innovación de Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - A. H. Clayton
- Department of Psychiatry & Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - S. A. Kingsberg
- Division of Behavioral Medicine, Department of Obstetrics & Gynecology, University Hospitals Cleveland Medical Center and Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - R. E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - S. J. Parish
- Weill Cornell Medical College, New York, NY, USA
| | - W. Wolfman
- Menopause Unit, Mount Sinai Hospital, Toronto, Canada
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada
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21
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Geng L, Zheng Y, Zhou Y, Li C, Tao M. The prevalence and determinants of genitourinary syndrome of menopause in Chinese mid-life women: a single-center study. Climacteric 2018; 21:478-482. [PMID: 29734845 DOI: 10.1080/13697137.2018.1458832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to explore the prevalence and determinants of genitourinary syndrome of menopause (GSM) in Chinese mid-life women. METHODS A cross-sectional single-center study was performed among 40-65-year-old women who participated in physical examinations at Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2015 to December 2016. The participating women were questioned about their genitourinary symptoms, and the relationships between these symptoms and the women's demographic characteristics were evaluated. RESULTS The prevalence of GSM was 30.8%, the most frequent symptom was decreased sexual desire (18.4%), and the frequency of vulvovaginal symptoms and lower urinary tract symptoms was 17.5% and 14.8%, respectively. In addition, most of the symptoms were mild. In postmenopausal women, the prevalences of GSM and the three aforementioned symptoms were higher than those in perimenopausal women (p < 0.05). Based on binary logistic regression analysis, GSM was found to be associated with postmenopause (p = 0.007; odds ratio (OR) 1.52), at least two abortions (p = 0.035; OR 1.42), body mass index (BMI) ≥ 30 kg/m2 (p = 0.032; OR 1.91) and diabetes (p = 0.041; OR 1.94). CONCLUSIONS GSM is common in Chinese mid-life women, and associations between GSM and postmenopause, abortion, BMI and diabetes were identified. Health-care practitioners should actively discuss urogenital symptoms with middle-aged female patients and take appropriate interventions to improve the health of their urogenital tract and quality of life.
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Affiliation(s)
- L Geng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zheng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zhou
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - C Li
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - M Tao
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
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22
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Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol 2018; 14:199-215. [PMID: 29393299 DOI: 10.1038/nrendo.2017.180] [Citation(s) in RCA: 303] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The symptoms of menopause can be distressing, particularly as they occur at a time when women have important roles in society, within the family and at the workplace. Hormonal changes that begin during the menopausal transition affect many biological systems. Accordingly, the signs and symptoms of menopause include central nervous system-related disorders; metabolic, weight, cardiovascular and musculoskeletal changes; urogenital and skin atrophy; and sexual dysfunction. The physiological basis of these manifestations is emerging as complex and related, but not limited to, oestrogen deprivation. Findings generated mainly from longitudinal population studies have shown that ethnic, geographical and individual factors affect symptom prevalence and severity. Moreover, and of great importance to clinical practice, the latest research has highlighted how certain menopausal symptoms can be associated with the onset of other disorders and might therefore serve as predictors of future health risks in postmenopausal women. The goal of this Review is to describe in a timely manner new research findings on the global prevalence and physiology of menopausal symptoms and their impact on future health.
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Affiliation(s)
- Patrizia Monteleone
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Giulia Mascagni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
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