Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause

Vaginal dryness is a common condition that is particularly prevalent during and after the menopause and it is one of the most important symptoms associated with vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underreported and undertreated. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. We evaluated the safety and beneficial effects of a new type of estrogen-free vaginal gel, Feminilove BIO-FRESH moisturizing vaginal gel, using in vitro and in vivo experimental tools. Our results suggest that; 1) Feminilove vaginal gel exhibits minimal cell cytotoxicity on various human vaginal cells; 2) Feminilove vaginal gel exhibits minimal side-effects on the structure of vaginal mucosa stratum of experimental animals; 3) Feminiove vaginal gel inhibits the growth of pathogenic vaginal bacteria (E. coli) while promotes the growth of beneficial vaginal bacteria (Lactobacillus spp); 4) Feminilove vaginal gel elicits an anti-inflammatory response on vaginal epithelial cells; and 5) Feminilove vaginal gel promotes the production of tropoelastin and collagen on cultural vaginal smooth muscle and may restore loose vaginal wall (i.e., tightening effects). In summary, our results indicate that Feminilove BIO-FRESH moisturizing vaginal gel is a safe and effective remedy for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women. Keyword: vaginal dryness, vulvovaginal atrophy, genitourinary syndrome of menopause, sexual dysfunction, vaginal lubrication, vaginal moisturizer

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Faculty Opinions recommendation of Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734324870.793582619 ◽

2021 ◽

Author(s):

Linda Cardozo

Keyword(s):

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Vulvovaginal Atrophy ◽

Genitourinary Syndrome

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Involutive changes in the vulvovaginal area

Russian Journal of Physiotherapy Balneology and Rehabilitation ◽

10.17816/1681-3456-2021-20-2-8 ◽

2021 ◽

Vol 20 (2) ◽

pp. 161-174

Author(s):

Sergei I. Surkichin ◽

Larisa S. Kruglova ◽

Inna A. Apolikhina ◽

Roman Yu. Mayorov ◽

Marika Avin

Keyword(s):

Quality Of Life ◽

Urinary Tract ◽

Bacterial Infections ◽

Signs And Symptoms ◽

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Yeast Infection ◽

Genitourinary Syndrome ◽

Methods Of Treatment

Involutional changes in the vulvovaginal area involve a series of transformations leading to vulvovaginal atrophy (VVA) during menopause. Signs and symptoms most often observed in this syndrome: vaginal dryness (54.4100%), dyspareunia (17.677.6%), burning (2.056.9%), itching (7.856.6%) and dysuria (5.936.1%). Other complaints include deformity of the vulva, irritation, and recurrent bacterial infections of the urinary tract or vagina, and yeast infection. Vaginal dryness, dyspareunia and irritation are the symptoms that most affect a woman's quality of life. The article analyzes modern ideas about the genitourinary syndrome of menopause. The questions of the mechanisms of occurrence are considered, a description of the clinical picture is given. The issues of treatment of atrophy of the vulvovaginal region are discussed in detail, in particular, special attention is paid to physiotherapeutic methods of treatment.

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Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause

Menopause The Journal of The North American Menopause Society ◽

10.1097/gme.0000000000001238 ◽

2018 ◽

Vol 25 (11) ◽

pp. 1339-1353 ◽

Cited By ~ 14

Author(s):

Fernand Labrie ◽

David F. Archer ◽

William Koltun ◽

Andrée Vachon ◽

Douglas Young ◽

...

Keyword(s):

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Vulvovaginal Atrophy ◽

Genitourinary Syndrome

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Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause

Menopause The Journal of The North American Menopause Society ◽

10.1097/gme.0000000000000571 ◽

2016 ◽

Vol 23 (3) ◽

pp. 243-256 ◽

Cited By ~ 103

Author(s):

Fernand Labrie ◽

David F. Archer ◽

William Koltun ◽

Andrée Vachon ◽

Douglas Young ◽

...

Keyword(s):

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Vulvovaginal Atrophy ◽

Genitourinary Syndrome

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Association of Vaginal Microbiota With the Genitourinary Syndrome of Menopause Across Reproductive Stages

Innovation in Aging ◽

10.1093/geroni/igaa057.554 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 171-171

Author(s):

Michelle Shardell ◽

Patti Gravitt ◽

Jacques Ravel ◽

Anne Burke ◽

Rebecca Brotman

Keyword(s):

Relative Abundance ◽

Female Genital Tract ◽

Signs And Symptoms ◽

Vaginal Microbiota ◽

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Menopausal Women ◽

Post Menopausal ◽

Genitourinary Syndrome ◽

Lactobacillus Spp

Abstract The genitourinary syndrome of menopause (GSM) is a collection of signs and symptoms related to estrogen decline that involves physical changes to the vulva, vagina, and lower urinary tract. GSM signs and symptoms may occur during any reproductive stage but are most common during menopause. Vaginal microbiota, particularly Lactobacillus spp., protect the female genital tract from multiple conditions; however, Lactobacillus spp. abundance declines during menopause. We aimed to determine the longitudinal association of vaginal microbiota with GSM signs and symptoms across reproductive stages. In a two-year cohort study comprising 750 women aged 35-60 years who contributed 2111 semiannual person-visits, low-Lactobacillus spp. vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and post-menopausal women, respectively (p<.001). After covariate adjustment, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were associated with vulvovaginal atrophy relative to high-Lactobacillus spp. communities dominated by L. crispatus (OR[Odds Ratio]=3.04, 95% Confidence Interval[CI]=1.02-9.06) among post-menopausal, but not among peri- or pre-menopausal women. Also, post-menopausal women with low-Lactobacillus spp. communities reported decreased libido (OR=1.79, 95%CI=1.04-3.12) and vaginal dryness (OR=1.61, 95%CI=0.89-2.90) more frequently than their counterparts with high-Lactobacillus spp. communities, but not among peri- or pre-menopausal women (p for interaction<.05). Specifically, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were related to both decreased libido (OR=2.82, 95%CI=1.11-7.14) and vaginal dryness (OR=3.50, 95%CI=1.18-10.44) compared with high-Lactobacillus spp. communities dominated by L. gasseri/L. jensenii. Vaginal microbiota, particularly Lactobacillus spp., and menopause may synergistically influence GSM.

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Current management of vaginal dryness

Russian Journal of Woman and Child Health ◽

10.32364/2618-8430-2021-4-3-250-253 ◽

2021 ◽

Vol 4 (3) ◽

pp. 250-253

Author(s):

T.V. Tazina ◽

◽

A.V. Knyazeva ◽

T.V. Bebneva ◽

◽

...

Keyword(s):

Quality Of Life ◽

Postmenopausal Women ◽

Special Focus ◽

Vaginal Mucosa ◽

Current Management ◽

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Vulvovaginal Atrophy ◽

Genitourinary Syndrome

The proportion of women of perimenopausal and postmenopausal age increases every year. Hormonal changes which are typical for these women are characterized by hypoestrogenism and a great diversity of clinical signs, e.g., vaginal dryness, irritation, itching, pain, burning, dyspareunia, and frequent urination. These symptoms occur at any age but are more common in postmenopausal women. Genitourinary syndrome of menopause (GSM) significantly reduces the quality of life of postmenopausal women. Among GSM presentations, vulvovaginal atrophy affects only vulvar and vaginal mucosa. Managing vulvovaginal atrophy in women of various ages is an important issue of gynecological practice. This paper describes current approaches to the treatment for vulvovaginal atrophy in women of various ages with a special focus on the association between vaginal dryness and the reduction of both general and sexual quality of life. In particular, non-hormonal topical medications are discussed. Knowing current (including international) approaches to address vaginal dryness are important for obstetrical gynecological practice. KEYWORDS: genitourinary syndrome of menopause, vulvovaginal atrophy, lubricants, vaginal moisturizers. FOR CITATION: Tazina T.V., Knyazeva A.V., Bebneva T.V. Current management of vaginal dryness. Russian Journal of Woman and Child Health. 2021;4(3):250–253 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-250-253.

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