Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management

• Published in: American journal of obstetrics and gynecology 2016-12, Vol.215 (6), p.704-711
• Main Authors: Gandhi, Jason, MS, Chen, Andrew, BA, Dagur, Gautam, MS, Suh, Yiji, Smith, Noel, MD, Cali, Brianna, BS, Khan, Sardar Ali, MD
• Format: Article
• Language: English
• Subjects: atrophic vaginitis; Atrophic Vaginitis - diagnosis; Atrophic Vaginitis - metabolism; Atrophic Vaginitis - physiopathology; Atrophic Vaginitis - therapy; Dehydroepiandrosterone - therapeutic use; dyspareunia; Dyspareunia - diagnosis; Dyspareunia - metabolism; Dyspareunia - physiopathology; Dyspareunia - therapy; Estrogen Replacement Therapy - methods; estrogen-progestin therapy; Female; genitourinary syndrome of menopause; Humans; hypoestrogenism; Life Style; Low-Level Light Therapy - methods; Lubricants - therapeutic use; menopausal hormone therapy; Menopause; nonhormonal vaginal therapy; Obstetrics and Gynecology; Oxytocics - therapeutic use; Oxytocin - therapeutic use; Quality of Life; Selective Estrogen Receptor Modulators - therapeutic use; Syndrome; urinary incontinence; Urinary Incontinence - diagnosis; Urinary Incontinence - metabolism; Urinary Incontinence - physiopathology; Urinary Incontinence - therapy; urogenital atrophy; vaginal maturation index; Vulvar Diseases - diagnosis; Vulvar Diseases - metabolism; Vulvar Diseases - physiopathology; Vulvar Diseases - therapy; vulvovaginal atrophy
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2016.07.045

Genitourinary syndrome of menopause, a new term for a condition more renowned as atrophic vaginitis, is a hypoestrogenic condition with external genital, urological, and sexual implications that affects >50% of postmenopausal women. Due to sexual embarrassment and the sensitive nature of discussing symptoms, genitourinary syndrome of menopause is greatly underdiagnosed. The most up-to-date literature pertaining to clinical manifestations, pathophysiology, etiology, evaluation, and management of genitourinary syndrome of menopause is comprehensively reviewed. Early detection and individually tailored pharmacologic (eg, estrogen therapy, selective estrogen receptor modulator, synthetic steroid, oxytocin, and dehydroepiandrosterone) and/or nonpharmacologic (eg, laser therapies, moisturizers and lubricants, homeopathic remedies, and lifestyle modifications) treatment is paramount for not only improving quality of life but also for preventing exacerbation of symptoms in women with this condition.