Urogenital atrophy is more common than it would first appear and women do not always seek advice and guidance. Confusion still exists between systemic hormone replacement therapy (HRT) and local estrogen preparations but new treatment modalities have emerged that extend the range of options beyond lubricants, moisturisers and vaginal estrogen preparations.
LevineKBWilliamsREHartmannKE.Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women.Menopause2008;
15: 661–666.
2.
SarrelPM.Effects of hormone replacement therapy on sexual psychophysiology and behavior in postmenopause. J Womens Health Gend Based Med2000;
9: S25–S32. Review. Erratum in: J Womens Health Gend Based Med 2001; 10: 91.
3.
DennersteinLRandolphJTaffeJet al.
Hormones, mood, sexuality, and the menopausal transition.Fertil Steril2002;
77: S42–S48.
4.
Banks J, Batty GD, Nazroo J, and Steptoe A. The dynamics of ageing: evidence from the English Longitudinal Study of Ageing 2002–15 (Wave 7). ESRC & IFS: London, 2016.
5.
SamsioeGJanssonIMellströmDet al.
Occurrence, nature and treatment of urinary incontinence in a 70-year-old female population.Maturitas1985;
7: 335–342.
6.
Van GeelenJMvan de WeijerPHArnoldsHT.Urogenital symptoms and resulting discomfort in non-institutionalized Dutch women aged 50–75 years.Int Urogynecol J Pelvic Floor Dysfunct2000;
11: 9–14.
7.
DavilaGWSinghAKarapanagiotouIet al.Are women with urogenital atrophy symptomatic?Am J Obstet Gynecol2003;
188: 382–388.
8.
NotelovitzMFunkSNanavatiNet al.
Estradiol absorption from vaginal tablets in postmenopausal women.Obstet Gynecol2002;
99: 556–562.
9.
SturdeeDWPanayNInternational Menopause Society Writing Group.
Recommendations for the management of post-menopausal vaginal atrophy.Climacteric2010;
13: 509–522.
10.
PortmanDJGassMLSKingsbergSet alGenitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the international society for the study of women’s sexual health and the North American Menopause Society Menopause. J North Am Menopause Soc2014;
21: 1063–1068.
11.
BlakemanPJHiltonPabd BulmerJN.Oestrogen and progesterone receptor expression in the female lower urinary tract, with reference to oestrogen status. BJU Int2000;
86: 32–38.
12.
SmithP.Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol- releasing vaginal ring.Acta Obstet Gynecol Scand Suppl1993;
157: 1–26.
13.
ZhuLLangJHFengREet al.Study on estrogen receptor around levator ani muscle for female stress urinary incontinence. Zhonghua Fu Chan Ke Za Zhi2004;
39: 655–657.
14.
SarrelPM.Sexuality and menopause.Obstet Gynecol1990;
75: 26S–30S; discussion 31S-35S.
15.
BachmannGALeiblumSR.The impact of hormones on menopausal sexuality: a literature review.Menopause2004;
11: 120–130.
16.
LaanEEveraerdWEversA.Assessment of female sexual arousal: response specificity and construct validity.Psychophysiology1995;
32: 476–485.
17.
BygdemanMSwahnML.Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women.Maturitas1996;
23: 259–263.
18.
BigliaNPeanoESgandurraPet al.
Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study.Gynecol Endocrinol2010;
26: 404–412.
19.
EdwardsDPanayN.Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?Climacteric2016;
19: 151–161.
20.
RosenADRosenT.Study of condom integrity after brief exposure to over the counter vaginal preparations. South Med J1999;
92: 305–307.
21.
NICE Menopause guideline: diagnosis and management [NG23]. November 2015.
Al-BaghdadiOEwiesAA.Topical estrogen therapy in the management of postmenopausal vaginal atrophy: an up-to-date overview.Climacteric2009;
12: 91–105.
24.
UlrichLSNaessenTEliaDet al. VAG-1748 trial investigators.
Endometrial safety of ultra-low- dose Vagifem 10 microg in postmenopausal women with vaginal atrophy.Climacteric2010;
13: 228–237.
25.
HaspelsAALuisiMKicovicPM.Endocrinological and clinical investigations in post-menopausal women following administration of vaginal cream containing oestriol. Maturitas1981;
3: 321–327.
26.
ConstantineGDSimonJAPickarJHet al:
REJOICE Study Group. The REJOICE trial: a phase 3 randomized, controlled trial evaluating the safety and efficacy of a novel vaginal estradiol soft-gel capsule for symptomatic vulvar and vaginal atrophy.Menopause2017;
24: 409–416.
27.
CardozoLBachmannGMcClishDet al.Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol1998;
92: 722–727.
28.
CardozoLLoseGMcClishDet al.
A systematic review of estrogens for recurrent urinary tract infections: third report of the hormones and urogenital therapy (HUT) committee.Int Urogynecol J Pelvic Floor Dysfunct2001;
12: 15–20.
29.
CardozoLLoseGMcClishDet al.
A systematic review of the effects of estrogens for symptoms suggestive of overactive bladder.Acta Obstet Gynecol Scand2004;
83: 892–897.
30.
SantMGaleaPBrincatMP. A comparative study between oestrogen replacement therapy, anticholinergic treatment and a combination of both in the management of detrusor instability in postmenopausal women. In: Book of Abstracts, The 10th World Congress on the menopause, Berlin 2002.
31.
NICE Urinary incontinence in women: management clinical guideline nice.org.uk/guidance/cg171 (2015).
32.
FantlJACardozoLMcClishDK.Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol1994; 83(1): 12–18.
33.
HenallaSMHutchinsCJRobinsonPet al.
Non-operative methods in the treatment of female genuine stress incontinence of urine.J Obstet Gynaecol2009;
9: 222–225.
34.
NappiREKokot-KierepaM.Vaginal health: insights, views & attitudes (VIVA) – results from an international survey.Climacteric2012;
15: 36–44.
35.
WoykaJTannaNAbernthyKet al.
A menopause service for women with breast cancer or at high risk from breast cancer.EJSO2009;
35: 1226–1227.
36.
PortmanDPalaciosSNappiREet al.
Ospemifene, a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial.Maturitas2014;
78: 91–98.
37.
ConstantineGGrahamSPortmanDJet al.Female sexual function improved with ospemifene in post-menopausal women with vulvar and vaginal atrophy: results of a randomized, placebo-controlled trial. Climacteric2015;
18: 226–232.
38.
CuiYZongHYanHet al.The efficacy and safety of ospemifene in treating dyspareunia associated with post-menopausal vulvar and vaginal atrophy: a systematic review and meta-analysis. J Sex Med2014;
11: 487–497.
39.
SimonJAAltomareCCortSet al.
Overall safety of ospemifene in postmenopausal women from placebo-controlled Phase 2 and 3 trials.J Womens Health (Larchmt)2018;
27: 14–23.
40.
SalvatoreSPitsouniEDel Deoet al.
Sexual function in women suffering from genitourinary syndrome of menopause treated with fractionated CO(2) laser.Sex Med Rev2017;
5: 486–494.
41.
GambaccianiMLevanciniMRussoEet al.
Long-term effects of vaginal erbium laser in the treatment of genitourinary syndrome of menopause.Climacteric2018;
21: 148–152.
42.
MikicANet al.
415 Use of vaginal erbium laser in treatment of vaginal relaxation syndrome and pelvic floor dysfunction.JISM2017;
14: S126–S127.
43.
LabrieFArcherDFKoltunWet al.Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause.Menopause2016;
23: 243–256.
44.
LabrieFArcherDFBouchardCet al.
Prasterone has parallel beneficial effects on the main symptoms of vulvovaginal atrophy: 52-week open-label study. Maturitas2015; 81(1): 46–56.
