Current management of vaginal dryness

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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Non-hormonal treatment for genitourinary syndrome of menopause

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2021-2-141-146 ◽

2021 ◽

Vol 20 (2) ◽

pp. 141-146

Author(s):

N.A. Tatarova ◽

◽

V.A. Linde ◽

S.N. Gusev ◽

◽

...

Keyword(s):

Quality Of Life ◽

Hormonal Treatment ◽

Therapeutic Effects ◽

Life Questionnaire ◽

Genitourinary Syndrome Of Menopause ◽

Quality Of Life Questionnaire ◽

Vulvovaginal Atrophy ◽

Positive Effects ◽

Genitourinary Syndrome

The genitourinary syndrome of menopause (GSM) is due to the development of atrophic and dystrophic processes in estrogendependent tissues and structures of the lower third of urinary tract in different periods of aging of the reproductive system. Nonhormonal treatment for GSM is considered as a first-line treatment and includes the use of gels, creams and suppositories that contribute to the restoration of hydrolipid balance, stimulating the collagen production that have an anti-inflammatory, antiseptic, regenerating effect, as well as increasing mucosal resistance and reducing the risk of adhesion of conditionally pathogenic infection. Objective. To evaluate the effectiveness, safety and acceptability of the vaginal cream for intimate hygiene EstrogialTM Plus in women with symptoms of vulvovaginal atrophy (VVA) and GSM. Patients and methods. 24 women aged 43 to 58 were examined. The inclusion criteria were the symptoms of GSM and VVA, the vaginal health index – no more than 20 points. During the course of the study, four visits were carried out, including standard observational procedures, filling the Quality of Life Questionnaire, the administration of treatment. The application of the cream Estrogial™ Plus in doses was prescribed 1 time per day on the vulvar vestibule for 30 days. The effectiveness of therapy was evaluated, all patients continued therapy for up to 60 days. According to the modified questionnaire for general clinical assessment, the state «very much improved» was revealed in 83.3% of patients with a severe form of GSM and VVA and in 66.7% with moderate VVA, «much improved» – in the rest. After treatment, 52% of patients had no symptoms of VVA, and 48% had symptoms in a mild form. Filling the Menopause-Specific Quality of Life Questionnaire (MENQOL), all 24 patients reported positive effects in the form of increased libido and reduced vaginal dryness during sexual intercourses. The study presents clinical cases of cured patients with GSM and VVA. Conclusion. The data obtained during the study make it possible to conclude that the intravaginal administration of the cream EstrogialTM Plus in doses is effective for the treatment of GSM and VVA. The proven therapeutic effects and safety of the use of local non-hormonal treatment enhance the prospects for providing treatment and preventive care for women during the menopausal transition and menopause. Key words: vulvovaginal atrophy, genitourinary syndrome of menopause, non-hormonal treatment, Estrogial™ Plus

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Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study

Climacteric ◽

10.1080/13697137.2017.1421921 ◽

2018 ◽

Vol 21 (2) ◽

pp. 167-173 ◽

Cited By ~ 17

Author(s):

E. Moral ◽

J. L. Delgado ◽

F. Carmona ◽

B. Caballero ◽

C. Guillán ◽

...

Keyword(s):

Quality Of Life ◽

Postmenopausal Women ◽

Genitourinary Syndrome Of Menopause ◽

Genitourinary Syndrome

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Safety and efficacy of a new vaginal gel, Feminilove, for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women: an in vitro and in vivo study

10.1101/2021.08.17.455703 ◽

2021 ◽

Author(s):

Albert Gonzalez ◽

Robert Lee ◽

Larry Booshehri ◽

David Grady ◽

Victoria Vaddi ◽

...

Keyword(s):

Vaginal Mucosa ◽

Minimal Cell ◽

Genitourinary Syndrome Of Menopause ◽

Vaginal Dryness ◽

Vulvovaginal Atrophy ◽

Vaginal Gel ◽

The Impact ◽

Genitourinary Syndrome

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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The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women

Menopause The Journal of The North American Menopause Society ◽

10.1097/gme.0000000000001148 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1418-1423 ◽

Cited By ~ 7

Author(s):

Eloy Moral ◽

Juan L. Delgado ◽

Francisco Carmona ◽

Borja Caballero ◽

Cristina Guillán ◽

...

Keyword(s):

Quality Of Life ◽

Postmenopausal Women ◽

Well Being ◽

Genitourinary Syndrome Of Menopause ◽

The Impact ◽

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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