Enhancing quality of life: addressing vulvovaginal atrophy and urinary tract symptoms.

IF 2.9 4区 医学 Q1 OBSTETRICS & GYNECOLOGY
Angelica Lindén Hirschberg
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引用次数: 0

Abstract

About 50% of postmenopausal women experience symptoms of vulvovaginal atrophy (VVA) including vulvovaginal dryness, burning, itching and dyspareunia as a natural physiological consequence of hypoestrogenism. These symptoms can have a major impact on quality of life and sexual function. VVA is a component of genitourinary syndrome of menopause, also associated with urinary tract problems such as frequent urination, urge incontinence and recurrent urinary tract infections. Vaginal low-dose estrogen is an effective treatment for symptoms of VVA, overactive bladder and urge incontinence, and prevents recurrent urinary tract infections. In contrast, systemic menopausal hormone therapy seems to worsen urinary incontinence. Women with breast cancer treated with aromatase inhibitors often have severe symptoms of VVA and urinary tract problems. Non-hormonal lubricants and moisturizers should be the first-line treatment in these patients. However, there is no evidence of increased cancer recurrence by low-dose vaginal estrogen in breast cancer survivors. When non-hormonal products are ineffective, low-dose vaginal estrogen could be considered in collaboration with the woman's oncologist. An individualized approach is required for the management of VVA and urinary tract symptoms. As VVA is a chronic condition, women should not be denied long-term use of vaginal estrogens if the treatment is of benefit to them.

提高生活质量:解决外阴阴道萎缩和尿路症状。
大约50%的绝经后妇女经历外阴阴道萎缩(VVA)的症状,包括外阴阴道干燥、灼烧、瘙痒和性交困难,这是雌激素分泌不足的自然生理后果。这些症状会对生活质量和性功能产生重大影响。VVA是更年期泌尿生殖系统综合症的一个组成部分,也与尿路问题有关,如尿频、急迫性失禁和反复尿路感染。阴道低剂量雌激素是治疗VVA症状、膀胱过度活动和急迫性尿失禁的有效方法,并可预防尿路感染复发。相反,全身绝经期激素治疗似乎加重尿失禁。接受芳香化酶抑制剂治疗的乳腺癌妇女通常有严重的VVA症状和尿路问题。非激素润滑剂和保湿剂应该是这些患者的一线治疗。然而,没有证据表明低剂量阴道雌激素会增加乳腺癌幸存者的癌症复发。当非激素产品无效时,低剂量阴道雌激素可以考虑与女性肿瘤医生合作。个体化治疗VVA和尿路症状是必要的。由于VVA是一种慢性疾病,如果治疗对她们有益,女性不应该被拒绝长期使用阴道雌激素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Climacteric
Climacteric 医学-妇产科学
CiteScore
1.70
自引率
7.10%
发文量
53
审稿时长
1 months
期刊介绍: Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.
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