Hum Matthew, Dytoc Marlene
1 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
2 Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada.
J Cutan Med Surg. 2017 Sep/Oct;21(5):418-424. doi: 10.1177/1203475417708165. Epub 2017 Apr 28.
Genitourinary syndrome of menopause (GSM) is a debilitating condition caused by hypoestrogenism that presents with vaginal dryness and dyspareunia as well as other genital, sexual, and urinary symptoms. Previously known as atrophic vaginitis, the term GSM is now used.
To help familiarise dermatologists with diagnosing and managing GSM.
In total, 218 articles were identified and reviewed by 2 independent authors using PubMed. Articles included were from December 2005 to December 2015. Sixty-seven articles met our inclusion criteria.
GSM is a clinical diagnosis, requiring the presence of symptoms that should be bothersome and not accounted for by another condition. A pH test may help with diagnosis as vaginal pH will be increased from acidic to neutral. The Papanicolaou test is not recommended because of poor clinical correlation. First-line treatment is low-dose local vaginal estrogen therapy, which has proven efficacy and safety. Serum estrogen levels are not significantly affected with the exception of creams containing high-dose conjugated equine estrogens. Other options have yet to be approved for use in Canada but show promise.
GSM is a debilitating and common condition that suffers from barriers to diagnosis and treatment. Current treatments are well tolerated, rewarding, and effective with rapid onset.
绝经泌尿生殖综合征（GSM）是一种由雌激素缺乏引起的使人衰弱的病症，表现为阴道干燥、性交困难以及其他生殖器、性和泌尿系统症状。该病症以前称为萎缩性阴道炎，现在使用GSM这一术语。
帮助皮肤科医生熟悉GSM的诊断和管理。
通过PubMed总共检索并由2名独立作者审阅了218篇文章。纳入的文章发表于2005年12月至2015年12月期间。67篇文章符合我们的纳入标准。
GSM是一种临床诊断，需要存在令人烦恼且不能用其他病症解释的症状。pH测试可能有助于诊断，因为阴道pH值会从酸性升高到中性。由于临床相关性差，不建议进行巴氏试验。一线治疗是低剂量局部阴道雌激素治疗，已证实其有效性和安全性。除含高剂量结合马雌激素的乳膏外血清雌激素水平不会受到显著影响。其他治疗选择在加拿大尚未获批使用，但显示出前景。
GSM是一种使人衰弱且常见的病症，在诊断和治疗方面存在障碍。目前的治疗耐受性良好、效果显著且起效迅速。
