University Hospitals Cleveland Medical Center, Cleveland, Ohio.
J Midwifery Womens Health. 2021 Nov;66(6):729-739. doi: 10.1111/jmwh.13277. Epub 2021 Aug 31.
Genitourinary syndrome of menopause (GSM) occurs in approximately 50% of menopausal women but is both underrecognized and undertreated despite numerous treatment options. Vaginal dryness, irritation, dyspareunia, urinary frequency, and urinary urgency are some of the more common symptoms that can have a negative effect on women's lives and relationships. Treatment options can include over-the-counter moisturizers and lubricants that can be composed of water or silicone or have an oil base. However, women and health care providers need be aware of the effects of excipients in these products so that the therapy does not cause vaginal irritation. US Food and Drug Administration (FDA)-approved treatment options include vaginally administered estrogen products as well as dehydroepiandrosterone (prasterone) and the selective estrogen receptor modulator ospemifene. The prescription options have proven efficacy and safety and can be considered for use by women with a history of cancer following collaboration with the oncologist. Despite the FDA warning that recommends vaginal lasers not be used for vaginal rejuvenation, vaginal lasers have also been used as a treatment for GSM, but studies on their safety are limited. This article reviews GSM, including its impact, diagnosis, and treatment.
绝经后生殖泌尿系统综合征（GSM）发生在大约 50%的绝经后女性中，但尽管有多种治疗选择，这种疾病仍然未被充分认识和治疗。阴道干燥、刺激、性交困难、尿频和尿急是一些较为常见的症状，这些症状可能对女性的生活和人际关系产生负面影响。治疗选择包括非处方保湿剂和润滑剂，这些产品可以由水或硅酮组成，也可以有油基。然而，女性和医疗保健提供者需要了解这些产品中赋形剂的影响，以免治疗引起阴道刺激。美国食品和药物管理局（FDA）批准的治疗选择包括阴道给予雌激素产品以及脱氢表雄酮（普拉睾酮）和选择性雌激素受体调节剂奥昔孕胺。这些处方选择已被证明具有疗效和安全性，并且可以考虑在与肿瘤学家合作后用于有癌症病史的女性。尽管 FDA 警告建议不要将阴道激光用于阴道年轻化，但阴道激光也被用作 GSM 的治疗方法，但关于其安全性的研究有限。本文回顾了 GSM，包括其影响、诊断和治疗。
