Angelou Kyveli, Grigoriadis Themos, Diakosavvas Michail, Zacharakis Dimitris, Athanasiou Stavros
Urogynecology Unit, Alexandra Hospital-National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2020 Apr 8;12(4):e7586. doi: 10.7759/cureus.7586.
The genitourinary syndrome of menopause (GSM) is a relatively new term for the condition previously known as vulvovaginal atrophy, atrophic vaginitis, or urogenital atrophy. The term was first introduced in 2014. GSM is a chronic, progressive, vulvovaginal, sexual, and lower urinary tract condition characterized by a broad spectrum of signs and symptoms. Most of these symptoms can be attributed to the lack of estrogen that characterizes menopause. Even though the condition mainly affects postmenopausal women, it is seen in many premenopausal women as well. The hypoestrogenic state results in hormonal and anatomical changes in the genitourinary tract, with vaginal dryness, dyspareunia, and reduced lubrication being the most prevalent and bothersome symptoms. These can have a great impact on the quality of life (QOL) of the affected women, especially those who are sexually active. The primary goal of the treatment of GSM is to achieve the relief of symptoms. First-line treatment consists of non-hormonal therapies such as lubricants and moisturizers, while hormonal therapy with local estrogen products is generally considered the "gold standard''. Newer therapeutic approaches with selective estrogen receptor modulators (SERMs) or laser technologies can be employed as alternative options, but further research is required to investigate the viability and scope of their implementation in day-to-day clinical practice.
更年期泌尿生殖综合征(GSM)是一个相对较新的术语,用于描述以前被称为外阴阴道萎缩、萎缩性阴道炎或泌尿生殖萎缩的病症。该术语于2014年首次提出。GSM是一种慢性、进行性的外阴阴道、性和下尿路病症,其特征是具有广泛的体征和症状。这些症状大多可归因于更年期所特有的雌激素缺乏。尽管该病症主要影响绝经后女性,但在许多绝经前女性中也可见到。雌激素缺乏状态导致泌尿生殖道出现激素和解剖学变化,其中阴道干燥、性交困难和润滑减少是最常见且令人困扰的症状。这些症状会对受影响女性的生活质量(QOL)产生重大影响,尤其是对那些有性生活的女性。治疗GSM的主要目标是缓解症状。一线治疗包括使用润滑剂和保湿剂等非激素疗法,而局部雌激素产品的激素疗法通常被视为“金标准”。选择性雌激素受体调节剂(SERM)或激光技术等新型治疗方法可作为替代选择,但需要进一步研究以探讨其在日常临床实践中的可行性和应用范围。