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更年期泌尿生殖综合征最新进展:基于个体化治疗方法的范围综述

Update on Genitourinary Syndrome of Menopause: A Scoping Review of a Tailored Treatment-Based Approach.

作者信息

Cuccu Ilaria, Golia D'Augè Tullio, Firulli Ilaria, De Angelis Emanuele, Buzzaccarini Giovanni, D'Oria Ottavia, Besharat Aris Raad, Caserta Donatella, Bogani Giorgio, Muzii Ludovico, Di Donato Violante, Giannini Andrea

机构信息

Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy.

Department of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 58-60, 20132 Milan, Italy.

出版信息

Life (Basel). 2024 Nov 19;14(11):1504. doi: 10.3390/life14111504.

Abstract

UNLABELLED

This scoping review explores the therapeutic strategies available for managing genitourinary syndrome of menopause (GSM), a condition often underdiagnosed and undertreated despite significantly affecting women's quality of life. GSM results from decreased estrogen levels during menopause, leading to a range of symptoms including vulvovaginal atrophy and urinary tract issues.

MATERIAL AND METHODS

we screened the literature for original studies with "menopause", "hormonal therapy", "vulvovaginal atrophy", "urinary incontinence", "urinary infections", "genitourinary syndrome".

RESULTS

A total of 451 relevant articles were retrieved. After screening, 19 articles were included in this scoping review.

DISCUSSION

First-line treatments typically include lubricants and moisturizers for short-term symptom relief, while unresolved or severe cases may warrant hormonal treatment. Topical hormonal treatments often have fewer side effects than systemic alternatives. Special attention is given to selective estrogen receptor modulators like ospemifene and steroid hormones like dehydroepiandrosterone (DHEA), which have shown beneficial effects on GSM symptoms. Moreover, innovative therapeutic approaches, such as laser treatment, are discussed in the context of their efficacy and accessibility. The safety of GSM hormonal therapy in women with a history or risk of cancer is also addressed, noting the need for more definitive research in this area. While there is a growing demand for tailored therapy, this scoping review emphasizes the importance of effective communication and counseling to allow women to make informed decisions about their treatment. Overall, this review underscores the need for increased awareness and further research into effective treatment options for GSM.

摘要

未标注

本综述探讨了可用于管理绝经后泌尿生殖综合征(GSM)的治疗策略,尽管该病症对女性生活质量有显著影响,但往往诊断不足且治疗不充分。GSM是由绝经期间雌激素水平下降引起的,会导致一系列症状,包括外阴阴道萎缩和泌尿系统问题。

材料与方法

我们在文献中筛选了关于“绝经”“激素治疗”“外阴阴道萎缩”“尿失禁”“尿路感染”“泌尿生殖综合征”的原始研究。

结果

共检索到451篇相关文章。筛选后,19篇文章纳入本综述。

讨论

一线治疗通常包括使用润滑剂和保湿剂以短期缓解症状,而未解决的或严重的病例可能需要激素治疗。局部激素治疗的副作用通常比全身治疗少。特别关注了选择性雌激素受体调节剂如奥培米芬和甾体激素如脱氢表雄酮(DHEA),它们对GSM症状显示出有益效果。此外,还在疗效和可及性的背景下讨论了创新治疗方法,如激光治疗。还讨论了有癌症病史或风险的女性中GSM激素治疗的安全性,指出该领域需要更多确定性研究。虽然对个性化治疗的需求不断增加,但本综述强调了有效沟通和咨询的重要性,以便女性能够就其治疗做出明智的决定。总体而言,本综述强调需要提高对GSM的认识,并进一步研究其有效治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71d4/11595908/7ce5cae0d415/life-14-01504-g001.jpg

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