Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, 27100, Pavia, Italy; Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100, Pavia, Italy.
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, 27100, Pavia, Italy; Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100, Pavia, Italy.
Best Pract Res Clin Endocrinol Metab. 2021 Dec;35(6):101595. doi: 10.1016/j.beem.2021.101595. Epub 2021 Oct 12.
Menopause represents an endocrine challenge to urogenital health, as oestrogens deprivation and androgens decline significantly contributes to age-related involution of vulvovaginal tissues and lower urinary tract. Genitourinary syndrome of menopause (GSM) is a clinical entity including the chronic and progressive condition of vulvovaginal atrophy (VVA) and encompassing both anatomical and functional consequences of menopause. The term GSM describes genital, sexual and urinary symptoms with a detrimental impact on quality of life (QOL). Several treatment options are available, but many barriers are still present to adequately diagnose and treat GSM. This review aims to present current evidences about epidemiology, aetiology, diagnosis and treatment of GSM, with a focus on prescription medications [low-dose local oestrogen therapy (LET), prasterone (DHEA) and the SERM ospemifene] for urogenital symptoms in healthy postmenopausal women and in special populations, including women with premature ovarian insufficiency (POI) and breast cancer survivors (BCS).
绝经代表了泌尿生殖健康的内分泌挑战，因为雌激素的缺乏和雄激素的下降显著导致与年龄相关的外阴阴道组织和下尿路的退化。绝经后泌尿生殖系综合征（GSM）是一种临床实体，包括慢性和进行性的外阴阴道萎缩（VVA），并包含绝经后解剖和功能后果。GSM 一词描述了对生活质量（QOL）有不利影响的生殖器、性和泌尿系统症状。有多种治疗选择，但仍存在许多障碍，无法充分诊断和治疗 GSM。本综述旨在介绍 GSM 的流行病学、病因学、诊断和治疗的最新证据，重点介绍处方药[低剂量局部雌激素治疗（LET）、普拉睾酮（DHEA）和 SERM 奥昔孕诺]治疗健康绝经后妇女和特殊人群的泌尿生殖系统症状，包括卵巢早衰（POI）和乳腺癌幸存者（BCS）妇女。
