Menopausal Syndrome Research Articles

Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

Современные возможности лечения вульвовагинальной атрофии: гормональные методы и лазерная модулирующая терапия

Vulvovaginal atrophy (VVA) is a common but underreported condition in real clinical practice caused by decreased estrogenization of the vaginal tissues. The prevalence of VVA in the postmenopausal phase is at least 50%, and according to some data, 80%. Not only patients, but also some physicians consider VVA as an inevitable part of the aging process, which delays the diagnosis and treatment of genitourinary syndrome of menopause (GSM). Treatment options for GSM are limited by contraindications to local hormone therapy, poor patient compliance, and hormonophobia. In this regard, the search for alternative non-invasive treatment methods is relevant. The search for literature for 2012–2022 was performed in PubMed, CochraneLibrary, Science Direct, and ELibrary databases using the following keywords: vulvovaginal atrophy, genitourinary syndrome of menopause, treatment, CO2-laser, postmenopausal age. Conclusion. Microablative fractional CO2-laser therapy for VVA can relieve symptoms and improve the condition of the vaginal mucosa by enhancing regeneration processes, but high-quality research is needed to study the efficacy and safety of this treatment method. Key words: vulvovaginal atrophy, genitourinary syndrome of menopause, perimenopause, postmenopause, therapy, laser therapy, CO2-laser

Локальная гормональная терапия генитоуринарного менопаузального синдрома

Aim: To justify the viability and safety of local hormonal therapy with oestrogens in genitourinary syndrome of menopause. Key points. The overall ageing of the population results in an increased number of women who have problems during menopause associated with gradual reduction and switching-off of ovarian function and cessation of oestrogen generation by ovaries. Local changes at the pelvic level (urethra, bladder, vagina) are described as genitourinary syndrome of menopause. The most effective therapies for the syndrome include local hormonal therapy with oestrogens, including oestriol which is of interest due to its specific targeted action and lack of proliferative effect on endometrium and mammary glands. The use of oestriol eliminates a number of problems caused by oestrogen insufficiency: it minimises or eliminates dyspareunea, dryness and itching in vagina and lower section of the urogenital tract, inappropriate urination, enuresis, and recurring vulvovaginitis and cystitis. Conclusion. It has been proven that the local use of oestriol is efficient and safe for the management of genitourinary syndrome of menopause. The selection of a specific medicinal product should be evidence-based and should take into account the route of administration and pharmacological properties, including preparation of the active ingredient, and excipients contributing to the overall efficiency and safety. Keywords: genitourinary syndrome, menopause, estriol, micronization.

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.

Laser technologies for genitourinary syndrome of menopause

Laser technologies for genitourinary syndrome of menopause

Transcutaneous Temperature Controlled Radiofrequency: Groundbreaking Technology - Female Stress Urinary Incontinence and Overactive Bladder Can Be Treated Noninvasively and with Vulvovaginal Rejuvenation?

It has long been difficult to treat vulvovaginal laxity, genitourinary syndrome of menopause, stress urine incontinence, overactive bladder (OAB), and other indications of sexual dysfunction because women traditionally find it difficult to discuss these difficulties with clinicians and because society generally accepts these diseases. Originating in esthetic medicine, noninvasive feminine rejuvenation that targets vaginal tissue with energy-based methods has recently become more popular. A more youthful-looking vulva, the restoration of vaginal elasticity and "tightness," a significant improvement in stress urinary incontinence, a reduction in symptoms of OAB, and a decrease in sexual dysfunction are all benefits of transcutaneous temperature-controlled radiofrequency (TTCRF) therapy at the vulvovaginal region. It is also becoming more popular as a mild-to-moderate stress urinary incontinence and OAB noninvasive therapy option. Women will likely always be appreciative of their gynecologist for managing stress urinary incontinence with TTCRF therapy without making an incision, it would appear.

Гинекологические аспекты сексуальной дисфункции в постменопаузальном периоде

Sexuality is defined as a physical, emotional, psychological, and social welfare state associated with sexual desires. The prevalence of sexual dysfunction among postmenopausal women is estimated to be 68% to 87%. The most significant causes of sexual disorders in this period are physiological changes of female body, psychological problems, lack of special knowledge, and male health status. Sexual function is linked to the complex neurotransmitter-hormone interaction both at the central and peripheral levels. The major cause of sexual dysfunction in postmenopausal women is genitourinary menopausal syndrome. Most commonly, gynecologist becomes a first contact physician dealing with female sexual disorders. Sexual dysfunction diagnosis in postmenopause includes the use of validated questionnaires, the assessment of the type and severity of menopausal disorders, the impact of somatic diseases and psychological issues, as well as a thorough physical examination. As sexual dysfunction in postmenopausal women is caused by multiple factors and has a complex pathogenesis, it is necessary to set up a multidisciplinary approach to problem solving. According to the biopsychosocial model, gynecologist has a wide range of therapeutic options for dealing with sexual disorders — pharmacotherapy (hormonal and non-hormonal agents), rational psychotherapy, and multimodal treatment methods. KEYWORDS: sexual dysfunction, postmenopause, sexual hormones, estrogens, androgens, genitourinary menopausal syndrome, biopsychosocial model of healthcare. FOR CITATION: Sandakova E.A., Zhukovskaya I.G. Gynecological aspects of sexual dysfunction in the postmenopausal women. Russian Journal of Woman and Child Health. 2023;6(1):26–30 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-26-30.

Insomnia in the menopause

During the menopause transition, pathogenetic changes begin to occur in the reproductive system and they affect the quality of sleep and contribute to the development of insomnia. Given the multifactorial nature of insomnia and the special characteristics of its pathogenesis, it is necessary to adhere to an integrated approach in the treatment of patients of the older age group. In our opinion, if we have indications, a promising direction for the treatment of sleep disorders during period of menopausal syndrome is the use of hormone replacement therapy in addition to traditional methods of the treatment of insomnia.

Elucidation of Immune Regulation Mechanism of Renshen Guben Oral Liquid by Network Pharmacology and Molecular Docking

Objective: To investigate the mechanism of Renshen Guben oral liquid (RSGB) enhancing immune function. Materials and Methods: Network pharmacology and molecular docking were used to intuitively demonstrate the mechanism of immune regulation of RSGB. Results: A total of 112 active compounds of RSGB were found, and 501 targets were predicted. Furthermore, 2974 immune targets were obtained from UniProt and NCBI Gene databases, and 111 common targets of RSGB and immunity were obtained. Among them, interleukin (IL) 6, tumor necrosis factor, AKT1, VEGFA, STAT3, MAPK1, SRC, EGFR, IL1B, and PTGS2 might be the key targets for RSGB to improve immunity. ClueGO and Kyoto Encyclopedia of Genes and Genomes analysis showed that the immunoregulatory mechanism of RSGB may find a relation with the B cell receptor signaling pathway and T cell receptor signaling pathway. Furthermore, this study preliminarily explored the mechanism of RSGB improving menopausal syndrome, polycystic ovary syndrome, and cancer-related fatigue by enhancing immunity. Conclusions: RSGB can improve the body’s immunity through multicomponent, multitarget, and multipathway. In addition, RSGB can also improve the immune capacity of the body to assist in the treatment of diseases, which has great potential as an immunomodulator.

Alternative methods of correction of the menopausal syndrome in patients with arterial hypertension

Alternative methods of correction of the menopausal syndrome in patients with arterial hypertension

Risk factors and pathogenetic mechanisms of genitourinary menopausal syndrome

Risk factors and pathogenetic mechanisms of genitourinary menopausal syndrome

Research Progress and Clinical Application of Chinese Medicine in the Treatment of Menopausal Syndrome

Research Progress and Clinical Application of Chinese Medicine in the Treatment of Menopausal Syndrome

MHT治疗绝经综合征的现况概括

MHT治疗绝经综合征的现况概括

Преждевременная недостаточность яичников: последствия для здоровья и стратегии заместительной гормональной терапии

Aim: analysis of modern views on the pathogenesis of complications and long-term consequences of sex hormone deficiency among patients with premature ovarian insufficiency (POI), as well as the possibilities and strategies of hormone replacement therapy (HRT) for their treatment and prevention. Key Points. The consequences of a sex hormones deficiency in women with POI are not only short-term clinical manifestations similar to menopause, but also long-term negative outcomes for general health and life. HRT has therapeutic and prophylactic potential for all clinical aspects of the disease. However, the currently developed standard therapeutic strategies do not always allow to completely stop the symptoms of POI and ensure reliable prevention of complications in the future. Conclusion. The choice of adequate doses and composition of HRT, along with an interdisciplinary approach to the treatment of this pathology, will make it possible to level the associated risks and ensure a high quality of life for patients. Keywords: premature ovarian insufficiency, hormone replacement therapy, cardiovascular diseases, osteoporosis, genitourinary menopausal syndrome.

Treatment With Vaginal Oxygen Therapy in Patients With Genitourinary Syndrome of Menopause Symptoms: An Observational Trial

Genitourinary Syndrome of Menopause (GSM) GSM is a chronic and progressive condition that can have many medical consequences (vaginal dryness, vulvar pain, dyspareunia, and dysuria) that may affect quality of life. The objective of our study was to evaluate the efficacy of vaginal hyperbaric oxygen treatment on GSM. Thirty patients received six weekly sessions of 95% pure oxygen that was delivered at a flow of 2 lt/ minute for 15 minutes using a cannula designed for vaginal therapy, with a subsequent follow-up after two months. There was a significant improvement in vaginal dryness (before treatment VAS 7.52 versus 3.52 after treatment -p = 0.05). The same improvement was observed for vulvar burning/pain and dyspareunia, but these were not statistically significant. VHI before treatment was 15.1 versus 19.59 after treatment (p = 0.05). All the parameters maintain their value at 2 months of follow-up. No adverse effects were observed.

Investigation on prevalence and risk factors associated with genitourinary syndrome of menopause in middle-aged and older women in Beijing community: a cross sectional study

BackgroundGenitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections) associated with menopause. To avoid invasive testing and painful physical examinations, validated questionaries, which can assess the prevalence and risk factors associated with symptoms of GSM. We aimed to investigate the prevalence and risk factors associated with GSM in middle-aged and older women in the communities of Beijing, China.MethodsA cross-sectional, questionnaire study was performed among 35–70 years old Chinese woman. Vaginal health index score and urinary distress inventory (UDI-6) was used to evaluate vulvovaginal atrophy (VVA) and urinary incontinence (UI). Stages of pelvic organ prolapse (POP) was measured during gynecological examination with POP-Q system. Mean ± standard deviation (SD) and proportion/percentages were used to summarize continuous and categorial variables respectively. The Bonferroni method was used to adjust for multiple comparisons.ResultsA total of 2702/3000 participants completed the questionnaire survey. The mean ± SD age of participants was 53.7 ± 7.0 years and prevalence of VVA among participants was 34.8% (941/2702). In UDI-6 questionnaires total 47.5% (1284/2702) participants reported experiencing urinary incontinence (UI). Further, POP was highly prevalent in anterior vaginal wall 38.9% (1050/2702) followed by posterior vaginal wall 25.3% (683/2702) and uterine 22.2% (599/2702). Besides, multiple logistic regression analysis inferred older age (45–54 years [OR (95% CI): 3.38 (2.03, 5.64)]; 55–64 years [OR (95% CI): 8.63 (5.09, 14.64)]), menopause [OR (95% CI): 2.20 (1.71, 2.85)] and Faecal Inconsistence (FI) [OR (95% CI): 1.31(1.00, 1.72)] as independent risk factors for VVA.ConclusionsOur study evidenced that GSM is prevalent in old age Chinese women. GSM is related with UI, POP and VVA. Further older age, menopause and FI were risk factors associated with VVA. Our findings could help health care personnel to get a comprehensive overview of factors associated with VVA and urinal distress, which may facilitate early detection and prevention of GSM.

Psychopersonal characteristics of women with varying degrees of menopausal disorders

The perimenopausal period is the age of the highest spiritual and intellectual development of a woman; therefore, neurovegetative and psycho-emotional disorders of this period acquire a pecial medical and social value and require an interdisciplinary approach.
 Objective: to identify the psychological characteristics of women with mild and moderate menopausal disorders in the perimenopausal period.
 Materials and methods. A total of 51 women were examined in the perimenopausal period: I main group - 20 patients with a low degree of CS, II main group - 16 women with menopausal disorders of moderate severity; the control group consisted of 15 healthy women. The severity of menopausal syndrome was determined using a modified menopausal Cooperman's index. All patients underwent psychodiagnostic examination using reactive and personal anxiety scales according to Ch.D. Spielberg and J.L. Hanina, G. Eisenko's test questionnaire, the Women's Sexual Function Index (FSFI) questionnaire, used the SF-36 (Medical Outcomes Study Short Form) general questionnaire to assess quality of life.
 Results. In women of the main groups, neurovegetative (14,5±2,6 and 26,6±4,2 points in the first and second groups of observation) and psycho-emotional disorders (4,9±1.3 and 11,2±1,6 points) prevailed. respectively). Hormone levels (FSH, E2, PRL) corresponded to perimenopausal values, but were significantly different from those of the control group. Identified individual-personal properties of women with the CS, in particular introversion and emotional instability. A comparative analysis on the Spielberg-Khanin scales showed that more than half (55,0 %) in the first main group and the majority (81,25 %) of women in the second main group versus 33,35 % in the control group (p˂0,05), a high level of personal anxiety was diagnosed; the average level of situational anxiety was highest among women in group II – 54,83±6,0 points versus 43,2±5,3 points in the first group and 36,3±4,8 points in patients without menopausal disorders (p˂ 0,05). In 24 (77,42 %) women of the main group, sexual dysfunction was detected, while its degree was greatest with moderately severe climacteric disorders. Menopausal disorders of varying severity, increased anxiety and neuroticism, sexual dysfunction affected the quality of life of patients.
 Conclusion. Formed psychopersonal characteristics of women with varying degrees of menopausal disorders in the perimenopausal period.

Hyaluronic Acid and Radiofrequency in Patients with Urogenital Atrophy and Vaginal Laxity.

Vaginal laxity (VL) and genitourinary syndrome of menopause (GSM), as well as aesthetic changes in the vulvar skin, often occur together and cause physical, psychological, and functional problems for women and their partners. The current study evaluated the efficacy of a nonsurgical radiofrequency device (RF) procedure combined with hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histological, and aesthetic levels. Twenty women with GSM and VL, aged between 36 and 72 (mean age 53.4), were treated with bipolar RF SECTUM, vaginal and vulvar application, as well as with a hyaluronic acid (HA) injection into the skin of the labia majora. The Vaginal Laxity Questionnaire (VLQ), Vaginal Health Index (VHI), and Female Sexual Function Index (FSFI) were used to examine the clinical effects of the operations. The Global Aesthetic Improvement Scale was utilized to measure patient satisfaction. On a histochemical level, the concentrations of elastin and collagen in the vaginal wall and vulvar skin were examined. Results: There was significantly higher patient satisfaction and a considerable clinical improvement across all areas of analysis. On the histochemical level, elastin and collagen fiber concentration increased after the treatment protocol both in the vulvar skin and in the vaginal wall: elastin in the vaginal wall, 11.4%, and in the vulvar skin, 61%; collagen in the vaginal wall, 26%, and in the vulvar skin, 27%. The current study demonstrated the efficacy and safety of this nonsurgical RF procedure combined with a hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histochemical, and aesthetic levels.

Bacterial Vaginosis in Postmenopausal Women.

Bacterial vaginosis (BV) is the most common vaginal infection worldwide, but most research has been conducted in premenopausal women. After menopause, endogenous estrogen production decreases, often leading to the genitourinary syndrome of menopause (GSM), characterized by vulvovaginal dryness and irritation. The estrogen-deficient postmenopausal state results in an elevated vaginal pH and depletion of vaginal lactobacilli. Use of traditional BV diagnostics (Amsel criteria, Nugent score) is difficult in post-menopausal women, especially those not on estrogen replacement therapy, as these methods were originally developed in premenopausal women. In this review, we discuss recent clinical data on BV in postmenopausal women, difficulties in diagnosis using traditional methods, the role of BV molecular diagnostics, and our current expert opinion for managing BV in this population. BV prevalence has been found to range between 2%-57% among postmenopausal women per Amsel and Nugent criteria. This is likely an over-estimate of the true prevalence due to limitations in these criteria which were only validated in pre-menopausal women. Despite increasing diagnostic options for BV in recent years, including highly sensitive and specific BV nucleic acid amplification tests (NAATs), the physiologic changes of menopause and limited inclusion of postmenopausal women in clinical studies, diagnosis is difficult in this population. Recent studies utilizing 16s rRNA gene sequencing suggest that the vaginal microbiota of premenopausal and postmenopausal women is quite different, even if BV is not present. Data also suggest that obese postmenopausal women have significantly lower rates of BV compared to non-obese postmenopausal women, although further research is needed in this area. Multiple treatment options exist for vaginal atrophy and BV in this population. Data are limited regarding optimal diagnostic approaches for BV in postmenopausal women; BV NAATs and 16s rRNA gene sequencing may have a role for diagnosing BV in symptomatic women although further studies are needed. Menopausal women with characteristic vaginal symptoms and an elevated vaginal pH should be initially treated for estrogen deficiency prior to considering a diagnosis of BV; subsequent treatment for BV should be driven by symptoms.

Correlation of Social Support through the Quality of Life of Menopausal Women at Puskesmas Kelurahan Pondok Bambu II, Duren Sawit District, East Jakarta in 2021

The increase in life expectancy in Indonesia has implications for the increase in the population of postmenopausal women. Menopausal women experience hormone deficiencies that cause complaints of vaginal atrophy, hot fluses, weight gain, bone pain, depression and others, which affect women's quality of life. This is supported by the results of research by Ruri Yuni, et al (2014) which states that 69.6% of menopausal women's quality of life is affected by menopausal syndrome. The purpose of the research: to determine the correlation of social support to the quality of life of women in dealing with menopausal life in the Puskesmas Pondok Bambu II Village. Research method: quantitative, with a cross sectional analytic design. The sample of this study was 45-55 years old postmenopausal women who had a family/husband in Puskesmas Kelurahan Pondok Bambu II area are 47 people. This research uses Purposive Sampling Technique. The results: from 47 respondents, menopausal women with social support with good quality of life were 20 respondents (76.9%), compared to menopausal women who received social support but had poor quality of life by 6 respondents (23.1%). The results of the Chi-Square test obtained p value of 0.003 which means that there is a relationship between social support and the quality of postmenopausal women.Conclusion Our study confirms the differences Quality of life of postmenopausal women between social support and non-social support. The impact of educational level, occupation and income and knowledge about menopause as predictors of a better quality of life in postmenopausal women.