Genitourinary syndrome of menopause: a systematic review on prevalence and treatment : Menopause

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Genitourinary syndrome of menopause: a systematic review on prevalence and treatment

Mili, Nikoletta MD; Paschou, Stavroula A. MD, PhD; Armeni, Anastasia MD, PhD; Georgopoulos, Neoklis MD, PhD; Goulis, Dimitrios G. MD, PhD; Lambrinoudaki, Irene MD, PhD

Author Information

12nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece

2Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece

3Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Address correspondence to: Irene Lambrinoudaki, MD, PhD, 4, Dorylaiou Street, GR-11521, Athens, Greece. E-mail: [email protected]

Received 9 November, 2020

Revised 18 December, 2020

Accepted 18 December, 2020

D.G.G. and I.L. contributed equally to this article.

Funding/support: None reported.

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's Website (www.menopause.org).

Menopause 28(6):p 706-716, June 2021. | DOI: 10.1097/GME.0000000000001752

Abstract

Importance: 

Genitourinary syndrome of menopause (GSM) consists of genitourinary tract symptoms that occur due to physical changes caused by estrogen concentrations decline after menopause. Unlike menopausal symptoms, which subside with time, GSM symptoms persist throughout a woman's life.

Objective: 

This article aimed to systematically review the literature to investigate the prevalence of GSM and its treatment.

Evidence Review: 

The search was conducted in the electronic databases PubMed, CENTRAL, and EMBASE until October 2020. Eligible for the systematic review were studies and surveys conducted via questionnaires or medical interviews evaluating the existence of GSM symptoms with or without gynecological examination in postmenopausal women or women >40 years of age.

Findings: 

After the application of predefined inclusion/exclusion criteria, 27 studies were included in the systematic review. The prevalence of GSM-related symptoms, such as vaginal dryness, irritation, itching, and dyspareunia, ranged from 13% to 87%. The use of GSM-specific treatment varied from 13% to 78%. Over-the-counter lubricants and moisturizers were the most popular therapeutic options (24.0%-85.5%), followed by low-dose vaginal estrogens (4.8%-35.0%). Vaginal health is not frequently discussed during doctor visits and awareness about the condition and the number of treatment options is low. Women are concerned about the long-term safety and side effects of hormonal treatment. The majority of women who suffer from genitourinary symptoms are dissatisfied by the treatment they have used.

Conclusions and Relevance: 

GSM is a highly prevalent condition among women. Nevertheless, women are frequently not aware of its cause and its treatment options. The findings of this review underline the need for education of patients and healthcare professionals regarding GSM diagnosis and treatment options.

 

Video Summary:https://links.lww.com/MENO/A720.

© 2021 by The North American Menopause Society

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