{"title":"Enhancing quality of life: addressing vulvovaginal atrophy and urinary tract symptoms.","authors":"Angelica Lindén Hirschberg","doi":"10.1080/13697137.2025.2514029","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Climacteric","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13697137.2025.2514029","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
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.
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.