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Genitourinary Syndrome of Menopause: Does Everyone Have It? 更年期泌尿生殖系统综合症:每个人都有吗?
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-03-01 Epub Date: 2023-11-16 DOI: 10.1097/GRF.0000000000000834
Jenny Doust, Annabelle Huguenin, Martha Hickey
{"title":"Genitourinary Syndrome of Menopause: Does Everyone Have It?","authors":"Jenny Doust, Annabelle Huguenin, Martha Hickey","doi":"10.1097/GRF.0000000000000834","DOIUrl":"10.1097/GRF.0000000000000834","url":null,"abstract":"<p><p>In 2014, the North American Menopause Society and the International Society for the Study of Women's Sexual Health recommended using the term genitourinary syndrome of menopause (GSM) to cover a range of genital and urinary symptoms that might be experienced during and after menopause. The term as currently defined, however, includes symptoms that may not be menopausal symptoms. The term GSM also includes \"objective\" measures such as vaginal pH that do not relate to symptom severity and are not priorities for clinicians or patients. We question the validity of GSM as a new syndrome and recommend the definition of the syndrome be revised to ensure it more closely reflects the symptoms attributable to menopause and the experience, difficulties, and response to treatment of those affected.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Postmenopausal Vaginal Microbiome and Genitourinary Syndrome of Menopause. 绝经后阴道微生物组与绝经期泌尿生殖系统综合征。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-03-01 Epub Date: 2023-11-20 DOI: 10.1097/GRF.0000000000000832
Elizabeth Micks, Susan D Reed, Caroline Mitchell
{"title":"The Postmenopausal Vaginal Microbiome and Genitourinary Syndrome of Menopause.","authors":"Elizabeth Micks, Susan D Reed, Caroline Mitchell","doi":"10.1097/GRF.0000000000000832","DOIUrl":"10.1097/GRF.0000000000000832","url":null,"abstract":"<p><p>This review summarizes our current understanding of associations of the postmenopausal vaginal microbiome with genitourinary syndrome of menopause. We review the normal postmenopausal microbiota, examine the association of the microbiome with vulvovaginal symptoms, describe microbial communities associated with physical and laboratory findings, and report the impact of different treatments for genitourinary syndrome of menopause on microbiota and symptom improvement. Postmenopausal vaginal symptoms have an underlying pathophysiology that has not been fully elucidated. Estrogen treatment may not be sufficient to relieve symptoms of vaginal discomfort in all postmenopausal individuals. In addition, other interventions targeted at changing the microbiota or pH do not consistently improve symptom severity.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexual Dysfunction and Dyspareunia in the Setting of the Genitourinary Syndrome of Menopause. 更年期泌尿生殖系统综合征下的性功能障碍和性冷淡
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-03-01 Epub Date: 2023-12-06 DOI: 10.1097/GRF.0000000000000846
Neha G Gaddam, Sheryl A Kingsberg, Cheryl B Iglesia
{"title":"Sexual Dysfunction and Dyspareunia in the Setting of the Genitourinary Syndrome of Menopause.","authors":"Neha G Gaddam, Sheryl A Kingsberg, Cheryl B Iglesia","doi":"10.1097/GRF.0000000000000846","DOIUrl":"10.1097/GRF.0000000000000846","url":null,"abstract":"<p><p>Sexual dysfunction is a common consequence of the genitourinary syndrome of menopause (GSM). In this book chapter, we discuss the pathophysiology, prevalence, evaluation, and evidence-based management of sexual dysfunction in patients affected by GSM. Additionally, we present an algorithm to guide clinicians in the management and treatment of sexual dysfunction in this setting based on available evidence and best practices.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genitourinary Syndrome of Menopause: Prevalence and Predictors. 更年期泌尿生殖系统综合征：发病率和预测因素
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-03-01 Epub Date: 2023-12-21 DOI: 10.1097/GRF.0000000000000847
Nancy F Woods, Joan F Shaver, Judith A Berg
{"title":"Genitourinary Syndrome of Menopause: Prevalence and Predictors.","authors":"Nancy F Woods, Joan F Shaver, Judith A Berg","doi":"10.1097/GRF.0000000000000847","DOIUrl":"10.1097/GRF.0000000000000847","url":null,"abstract":"<p><p>The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSM measures; and assessing biases in completed research.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genitourinary Syndrome of Menopause in Cancer Survivors. 癌症幸存者更年期泌尿生殖系统综合征。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-18 DOI: 10.1097/grf.0000000000000848
Catherine L Dugan, Alisha A Othieno, Mindy E Goldman
{"title":"Genitourinary Syndrome of Menopause in Cancer Survivors.","authors":"Catherine L Dugan, Alisha A Othieno, Mindy E Goldman","doi":"10.1097/grf.0000000000000848","DOIUrl":"https://doi.org/10.1097/grf.0000000000000848","url":null,"abstract":"Genitourinary syndrome of menopause (GSM) encompasses the symptoms of estrogen deprivation in the vaginal, vulva, and bladder areas. Because many cancer treatments induce a hypoestrogenic state, GSM is common in cancer survivors. The number of cancer survivors is increasing, and the unique aspects of GSM management for cancer survivors, such as the safety of hormonal therapies, is important to understand. In this review, we cover important considerations in the assessment of GSM; nonpharmacologic, behavioral, integrative, pharmacologic, and medical device treatments for GSM: the unique considerations in GSM by cancer treatment modality; bladder manifestations of GSM; and GSM in specific populations.","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrated Care for Pregnant and Parenting People with Substance Use. 为使用药物的孕妇和育儿者提供综合护理。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-14 DOI: 10.1097/grf.0000000000000831
Kaylin A Klie, Sarah Nagle-Yang, Lulu Zhao, Melanie E Fringuello
{"title":"Integrated Care for Pregnant and Parenting People with Substance Use.","authors":"Kaylin A Klie, Sarah Nagle-Yang, Lulu Zhao, Melanie E Fringuello","doi":"10.1097/grf.0000000000000831","DOIUrl":"https://doi.org/10.1097/grf.0000000000000831","url":null,"abstract":"Caring for pregnant people with substance use requires knowledge about specific substances used, treatment options, and an integrated, trauma-informed care team. This chapter will discuss crucial information for clinicians regarding evidence-based practice for screening, intervention, and ongoing support for pregnant people and their families impacted by substance use.","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138689094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fetal Growth and Antenatal Testing in Uncomplicated Multiple Gestations. 非复杂多胎妊娠的胎儿生长和产前检查。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2023-09-22 DOI: 10.1097/GRF.0000000000000815
Sarah K Shea, Roger B Newman
{"title":"Fetal Growth and Antenatal Testing in Uncomplicated Multiple Gestations.","authors":"Sarah K Shea, Roger B Newman","doi":"10.1097/GRF.0000000000000815","DOIUrl":"10.1097/GRF.0000000000000815","url":null,"abstract":"<p><p>Multiple gestations experience a slowing of fetal growth in the third trimester and have been described as having a higher risk of growth restriction. Whether this increased diagnosis of fetal growth restriction is physiological or pathologic is controversial. In an attempt to better identify those fetuses most at risk, twin-specific growth charts have been developed and tested. In addition, there are data to suggest that multiple gestations experience an increased risk of unexpected third-trimester stillbirth in apparently uncomplicated pregnancies. This chapter reviews the current data and recommendations for fetal growth assessment, antenatal surveillance, and delivery timing in uncomplicated multiple gestations.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medication Abortion: A Comprehensive Review. 药物流产：综述。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.1097/GRF.0000000000000812
Erin Fleurant, Leanne McCloskey
{"title":"Medication Abortion: A Comprehensive Review.","authors":"Erin Fleurant, Leanne McCloskey","doi":"10.1097/GRF.0000000000000812","DOIUrl":"10.1097/GRF.0000000000000812","url":null,"abstract":"<p><p>This chapter provides an overview of evidence-based guidelines for medication abortion in the first trimester. We discuss regimens, both FDA-approved and other clinical-based protocols, and will briefly discuss novel self-managed abortion techniques taking place outside the formal health care system. Overview of patient counseling and pain management are presented with care to include guidance on \"no touch\" regimens that have proven both feasible and effective. We hope that this comprehensive review helps the health care community make strides to increase access to abortion in a time when reproductive health care is continuously restricted.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pain Management in Abortion Care. 流产护理中的疼痛管理。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2023-09-14 DOI: 10.1097/GRF.0000000000000807
Johana Oviedo, Colleen C Denny
{"title":"Pain Management in Abortion Care.","authors":"Johana Oviedo, Colleen C Denny","doi":"10.1097/GRF.0000000000000807","DOIUrl":"10.1097/GRF.0000000000000807","url":null,"abstract":"<p><p>Both medication and procedural abortion are associated with pain. The experiences of pain depend on both physical and emotional factors. Several pain management options are available for abortion, depending on abortion type, clinical setting, and patient considerations, and a comprehensive approach is necessary to optimize pain management.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
First Trimester Ultrasound and Aneuploidy Screening in Twins. 妊娠早期超声和双胞胎非整倍体筛查。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2023-07-13 DOI: 10.1097/GRF.0000000000000797
Maeve K Hopkins, Olivia Neumann, Jeffrey A Kuller, Lorraine Dugoff
{"title":"First Trimester Ultrasound and Aneuploidy Screening in Twins.","authors":"Maeve K Hopkins, Olivia Neumann, Jeffrey A Kuller, Lorraine Dugoff","doi":"10.1097/GRF.0000000000000797","DOIUrl":"10.1097/GRF.0000000000000797","url":null,"abstract":"<p><p>All patients with twin pregnancy should have first trimester ultrasound and be offered screening for chromosomal aneuploidy as well as diagnostic testing. Screening for aneuploidy in twins presents unique challenges compared with singletons. Cell-free DNA screening should be considered first-line; however, this option may not be available or may have limitations in certain clinical scenarios, such as vanishing twins. If cell-free DNA screening is not available, maternal serum marker screening in conjunction with nuchal translucency assessment should be offered. Patients with positive aneuploidy screening tests or fetal structural abnormalities should be offered diagnostic testing.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9772934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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