Abstract
Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.
Highlights
Menopause is a gradual and physiological event due to ovarian failure and consequent hypoestrogenism, which significantly affects the lower genital tract
Several denominations are used to describe the alterations noticed in the lower genital tract, such as atrophic vaginitis, vulvovaginal atrophy (VVA), and, lately, genitourinary syndrome of menopause (GSM) [1,2,3]
Vulvovaginal atrophy of any degree is present in 15% of premenopausal women and in 40– 54% of postmenopausal women [4, 5]
Summary
Ana Paula Ferreira Costa 1*, Ayane Cristine Alves Sarmento 1, Pedro Vieira-Baptista 2,3, José Eleutério Jr. 4, Ricardo Ney Cobucci 5 and Ana Katherine Gonçalves 1,6. Reviewed by: Akmal El-Mazny, Cairo University, Egypt Mohamed Farghali, Ain Shams University, Egypt. Specialty section: This article was submitted to Gynecology, a section of the journal Frontiers in Reproductive Health
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