Menopausal Syndrome Research Articles

Use of laser and radiofrequency for genitourinary syndrome of menopause: do Brazilian women know it? / Laser e rádio frequência como opções terapêuticas na síndrome geniturinária da menopausa: as mulheres brasileiras conhecem?

Objective: to verify how many women between 35 and 69 years old would undergo laser and/or radiofrequency as treatment for genitourinary syndrome of menopause and how many report improvements after having undergone for those procedures. The study also seeks to identify how many women resort to these treatments for aesthetic reasons and how many as genitourinary syndrome of menopause symptom relief. The whole research was done in Brazil. Methods: literature review followed by the formulation of a Google Forms questionnaire that was sent to 339 Brazilian women. Female individuals participated in the research, regardless of race, education, religious belief, or number of children. The collected data was descriptively analyzed; Pearson’s chi-squared test was used when appropriated. Results: 173 responses were obtained, 170 of which were used, and three were excluded due to inconsistencies. Of the 170 respondents, 79 were in menopause, and six already have undergone the mentioned treatments. The main symptoms presented by women in menopause were vaginal dryness (79,7%) and urinary incontinence (51,9%). A minority of the participants reported having knowledge regarding the treatments. Conclusion: Although the treatment effectiveness in improving genitourinary syndrome of menopause, they are not widely known by women. This highlights the need for a greater dissemination of information regarding these therapeutic options.

Treatment of Postmenopausal Syndrome with UBPN01: A Randomized, Double-blind, Placebo-controlled Study

This study evaluated the efficacy of UBPN01 (Salvia miltiorrhiza extract) for alleviating menopausal syndrome. This study was a randomized, double-blind, placebo-controlled clinical trial involving female subjects (40 – 60 years) with menopausal syndrome. Subjects were administered 600 mg/day UBPN01 or placebo, and efficacy endpoints were menopausal symptoms according to the total Kupperman Index (KI) score and individual categories. After 12 weeks, the total KI scores decreased and depression and vaginal dryness symptoms improved, especially in UBPN01 compared to placebo. Moreover, we observed no significant difference between the two groups in estradiol, follicle stimulating hormone, or luteinizing hormone. These results demonstrated that UBPN01 alleviates menopausal symptoms without notable side effects and improves quality of life, suggesting its efficacy as an alternative supplement for women ineligible for hormone therapy.

Systemic or Vaginal Hormone Therapy After Early Breast Cancer: A Danish Observational Cohort Study.

BackgroundWomen treated for breast cancer (BC) often suffer genitourinary syndrome of menopause. These symptoms may be alleviated by vaginal estrogen therapy (VET) or menopausal hormone therapy (MHT). However, there are concerns of risks of recurrence of BC and death following treatment.MethodsOur study included longitudinal data from a national cohort of postmenopausal women, diagnosed 1997-2004 with early-stage invasive estrogen receptor–positive nonmetastatic BC, who received no treatment or 5 years of adjuvant endocrine therapy. We ascertained prescription data on hormone therapy, VET or MHT, from a national prescription registry. We evaluated mortality and risk of recurrence associated with use of VET and MHT vs non-use using multivariable models adjusted for potential confounders.ResultsAmong 8461 women who had not received VET or MHT before BC diagnosis, 1957 and 133 used VET and MHT, respectively, after diagnosis. Median follow-up was 9.8 years for recurrence and 15.2 years for mortality. The adjusted relative risk of recurrence was 1.08 (95% confidence interval [CI] = 0.89 to 1.32) for VET (1.39 [95% CI = 1.04 to 1.85 in the subgroup receiving adjuvant aromatase inhibitors]) and 1.05 (95% CI = 0.62 to 1.78) for MHT. The adjusted hazard ratios for overall mortality were 0.78 (95% CI = 0.71 to 0.87) and 0.94 (95% CI = 0.70 to 1.26) for VET and MHT, respectively.ConclusionsIn postmenopausal women treated for early-stage estrogen receptor–positive BC, neither VET nor MHT was associated with increased risk of recurrence or mortality. A subgroup analysis revealed an increased risk of recurrence, but not mortality, in patients receiving VET with adjuvant aromatase inhibitors.

Unkeito Suppresses RANKL-Mediated Osteoclastogenesis via the Blimp1–Bcl6 and NF-κB Signaling Pathways and Enhancing Osteoclast Apoptosis

Osteoporosis is a common bone disease, particularly in menopausal women. Herein, we screened four Kampo medicines (Unkeito (UKT), Kamishoyosan (KSS), Kamikihito (KKT), and Ninjinyoeito (NYT)), frequently used to treat menopausal syndromes, for their effects on receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation in RAW 264 cells. Considering that UKT exhibited the most potent effect, we examined its effect on RANKL-induced osteoclastogenesis, the induction of osteoclast apoptosis, and the mechanisms underlying its effects. UKT inhibits RANKL-induced osteoclast differentiation in the early stage and decreases osteoclast-related genes, including tartrate-resistant acid phosphatase (Trap), dendritic cell-specific transmembrane protein (Dcstamp), matrix metalloproteinase-9 (Mmp9), and cathepsin K (Ctsk). Specifically, UKT inhibits the nuclear factor of activated T cells 1 (NFATc1), which is essential for osteoclastogenesis. UKT increases Bcl6, which antagonizes NFATc1 and Dc-stamp, thereby blocking the progression of osteoclasts to maturation. UKT also decreased nuclear translocation by downregulating the activity of p65/NF-κB. In addition, UKT enhances mononuclear osteoclast apoptosis via activation of caspase-3. Herein, we demonstrate that UKT suppresses RANKL-mediated osteoclastogenesis via the Blimp1–Bcl6 and NF-κB signaling pathways and enhances mononuclear osteoclast apoptosis. Furthermore, UKT prevents bone loss in OVX mice. Thus, UKT might be a potential therapeutic agent for postmenopausal osteoporosis.

Evaluation of the Effectiveness of Fermented Soybean-Lettuce Powder for Improving Menopausal Symptoms.

Menopause syndrome causes a decline in the quality of life of postmenopausal women. Hormone therapy is recommended for the treatment of menopausal syndromes. However, it has several side effects. Soybean has been safely used to relieve the symptoms of menopause. Lettuce has antidiabetic and anti-inflammatory effects and improves sleep quality. Natural nitric oxide metabolites are produced through fermentation, which increases the effectiveness of the functional substances. This study assessed the alleviation of menopausal syndrome symptoms by natural nitric oxide-containing soybean lettuce extract using the Kupperman index. This study included adult women with menopausal syndrome and a Kupperman index of ≥15. After a four-week study with 40 participants, the final analysis included 39 participants in the experimental group (n = 19) and the placebo group (n = 20). Body mass index, waist circumference, and the total cholesterol, low-density and high-density lipoprotein cholesterol, and triglyceride levels were not altered before and after treatment in both groups. There was a significant decrease in the Kupperman index after treatment in the experimental group, but no significant change was observed in the placebo group. Soybean lettuce extract alleviates menopause syndrome without any special side effects.

Biopsychosocial risk factors of depression during menopause transition in southeast China

ObjectiveMore than 2 billion women are experiencing menopause transition in China and some of them suffered from depression; while the risk factors of depression during menopause transition were still unclearin China. We aimed to investigate the risk factors in mid-life women in Southeast China.MethodThis study included 1748 Chinese women aged 40–65 years-old who visited gynecology outpatient department of Women’s hospital School of Medicine, Zhejiang University during 2010–2018. Demographic information was collected, and the modified Kupperman Menopausal Index (mKMI) and Hamilton Rating Scale for Depression were assessed. Circulating levels of sex hormones were tested. Ordinal logistic regression analysis was performed to identify risk factors for depression.ResultsThe prevalence of depression symptoms was 47.43%. The majority of women had mild (38.56%) or moderate depressive symptoms (8.00%); only 0.86% had severe depressive symptoms. Compared with perimenopausal women, postmenopausal women had increased risks of more severe depression. The associations between menopausal syndromes and the intensity of depression were strongly positive (OR 6.69, 95% CI 5.39–8.29). Elder age, higher follicle stimulating hormone levels, lower estradiol levels, and fewer parity were positively related with the intensity of depression. Among postmenopausal women, underweight, mKMI > 14, earlier age at menopause, shorter reproductive period, and longer duration after menopause were risk factors for incresed intensity of depression.ConclusionsThe results demonstrated a high proportion of depression in women complaining of menopause. Menopausal symptoms were strongly related to the intensity of depression. In postmenopausal women, estrogen related events are associated with the intensity of depression. Gynecological endocrinologists in China should consider screening for depression in high-risk women.

The 2022 hormone therapy position statement of The North American Menopause Society.

"The 2022 Hormone Therapy Position Statement of The North American Menopause Society" (NAMS) updates "The 2017 Hormone Therapy Position Statement of The North American Menopause Society" and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2017 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Advisory Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause and has been shown to prevent bone loss and fracture. The risks of hormone therapy differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing therapy.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is favorable for treatment of bothersome VMS and prevention of bone loss. For women who initiate hormone therapy more than 10 years from menopause onset or who are aged older than 60 years, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS, with shared decision-making and periodic reevaluation. For bothersome genitourinary syndrome of menopause symptoms not relieved with over-the-counter therapies in women without indications for use of systemic hormone therapy, low-dose vaginal estrogen therapy or other therapies (eg, vaginal dehydroepiandrosterone or oral ospemifene) are recommended.

P-493 Sex and fertility education in the UK: an analysis of biology curricula and students’ experiences

Study questionWhat is currently being taught in United Kingdom (UK) secondary schools relating to sex and fertility and what are students’ experiences of this education?Summary answerThere are large gaps in the UK’s biology curriculum relating to sex and fertility education with important topics being neglected.What is known alreadySex and fertility education is essential to enable people to make informed choices about family building. This is especially important as maternal and paternal age is increasing globally. School is an important source of this education but sex and fertility education is often minimal. In order to optimise people’s contraceptive behaviour and fertility planning, an understanding of the reproductive cycle, basic physiology of fertility and preconception health is required. Fertility education interventions have been shown to improve fertility knowledge and decrease planned ages of childbearing among young adults but only if repeated.Study design, size, durationThis study aimed to evaluate the current biology curricula relating to sex and fertility education at GCSE (General Certificate of Secondary Education) and A level (Advanced Level) in the UK and to determine 16-17-year-old students’ experiences of their sex and fertility education. This year group was chosen as we are interested in what students have learnt by the end of their mandatory education (years 1 to 11), and their experiences of this education.Participants/materials, setting, methodsThe analysis of the curricula was conducted using the most recently published specifications for science and biology at GCSE and biology at A level for the Awarding Bodies that dominate the GCSE and A-level market in the UK. The school survey included a 47-item online survey distributed to year 12 students in four secondary schools across England. In total, 244 students participated in the survey.Main results and the role of chanceThere are six Awarding Bodies in the UK that set the examinations for GCSE and A-level students. At GCSE level, the hormonal control of the menstrual cycle, contraception and ART are taught within the human reproduction section of the biology curriculum. STIs are used as examples of communicable diseases, but pregnancy does not feature other than as a consequence of contraceptive failure. At A level, there is generally less teaching of relationships, sexuality and fertility-related topics than at GCSE. The results of the school survey showed that some topics, notably puberty, the menstrual cycle, contraception and STIs, were more likely to be learnt in school. However, topics such as endometriosis, menopause, miscarriage and polycystic ovarian syndrome were more likely to be learnt outside school. Abortion was the most common topic learnt outside school, followed by puberty. The most popular sources of sex education outside school were the internet and social media. In the students’ responses to how they think sex and fertility education can be improved, six themes became apparent: LGBTQ + (lesbian, gay, bisexual, transgender, queer and others) inclusivity; topic variety; logistical improvements; attitudes towards sex; gender equality; and applicability to real life.Limitations, reasons for cautionThe COVID-19 pandemic significantly disrupted schools during the 2020/2021 academic year. Consequently, we were unable to distribute the survey to as many schools as planned. We hope to continue this study in the 2021/2022 academic year to allow further comparison between the experiences of different groups of students.Wider implications of the findingsIdeally, school sex and fertility education would involve a comprehensive and holistic programme and would provide young people with full, accurate information to prepare them for later life. We hope that the results of our study can be used to improve sex and fertility education for young people.Trial registration numberNA

Study on the active components and mechanism of Suanzaoren decoction in improving cognitive impairment caused by sleep deprivation

Ethnopharmacological relevanceSuanzaoren Decoction (SZRD) is a traditional and classic prescription for the treatment of insomnia, with a history of more than 1,000 years. It replenishes blood components, calms the nerves, reduces fever and irritability. It is commonly used in the clinical treatment of chronic fatigue syndrome, cardiac neurosis, and menopausal syndromes. Modern pharmacological studies have shown that it improves cognitive impairment; however, its mechanism of action remains unclear. Aim of the studyThis study preliminarily investigated the potential bioactive components and mechanism of SZRD in improving cognitive impairment by exploring network pharmacology, molecular docking, and conducting in vivo experiments. Materials and methodsThe components of various Chinese herbs in SZRD and their disease-related targets were identified through network pharmacology and literature. Gene ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of intersection targets were performed using the relevant database. Next, the “Components-Targets-Pathways” (C-T-P) and “Protein-Protein interaction” networks were constructed using the enrichment analysis results to further identify potential pathways, bioactive components, and hub genes. At the same time, molecular docking was used to further distinguish the key bioactive components and genes of SZRD responsible for improving cognitive impairment. Finally, the potential mechanism of action was further analysed and verified using in vivo experiments. ResultsA total of 117 potential active components and 138 intersection targets were identified by network pharmacology screening. The key bioactive components, including calycosin, 5-Prenylbutein, licochalcone G, glypallichalcone, and ZINC189892, were identified by analysing the networks and molecular docking results. Hub genes included ACHE, CYP19A1, EGFR, ESR1, and ESR2. The oestrogen signalling pathway was the most important in the enrichment analysis. In vivo experiments further proved that SZRD could improve cognitive impairment by affecting the oestrogen signalling pathway and the expression of ACHE and CYP19A1. ConclusionsNetwork pharmacology and in vivo experiments demonstrate that SZRD improves cognitive impairment caused by sleep disturbance through estrogen receptor pathway, which provides a basis for its clinical application.

Clinical presentations of genitourinary syndrome of menopause (GSM) among menopause women

Genitourinary syndrome of menopause (GSM) is a new term that describes a variety of menopausal symptoms and signs that include not only genital symptoms, sexual symptoms, and impaired function, but also urinary tract symptoms. GSM is caused not only by estrogen deficiency but also by degenerative effects and other bladder and pelvic floor processes. This study aimed to detect GSM symptoms in menopausal women in order to be able to provide effective therapy that is appropriate for improving menopausal women's quality of life. A cross-sectional study was conducted in which data of 32 menopausal women who met the inclusion criteria from December to May 2022 were collected at Arifin Achmad Hospital in Pekanbaru, Riau, Indonesia. The age of menopausal women included in this study ranged between 40?71 years and 43.8% patients had 15 years of length menopause. There were 40.6% of patient reported vaginal dryness, 72% felt pain or heat during urination and 96.9% had no recurrent urinary tract infections. Other complaints that were also reported were feeling less orgasm during sexual intercourse (54.9%) and having vaginal discharge (21.9%). Mother bothersome symptoms (MBS) was also reported that included phonophobia (9.4%), nausea (16.1%), and photophobia (6.6%). In conclusion, several complaints of menopausal individuals were reported this included vagina dryness, pain or burning when urinating, less orgasm during sexual intercourse, having vaginal discharge, and having complaints of fear, anger, and anxiety when hearing certain sounds that trigger negative emotions. These findings can be used to understanding the menopausal individuals and to be able to provide appropriate measures to ensure good quality of life to this community.

Personalized use of minor food components in the menopause period

In the Russian Federation, the number of women in peri- and postmenopause is more than 21 million [1]. In addition to changes in sex hormone levels associated with menopause, its timing is an important predictor of future health outcomes, such as the duration of vasomotor symptoms and the risk of developing hormone-dependent tumors. The influence of reproductive factors (e.g., age at menarche, pregnancy) and sociodemographic factors on intermediate and long-term health outcomes of menopause has been extensively studied in the past. However, the influence of a woman’s diet on the course of menopause has not been studied sufficiently. There is also little evidence in the literature on the impact of diet at a young age, the so-called established eating patterns, on the menopause course. The authors aim to study the actual nutrition of menopausal women with manifestations of climacteric syndrome and make an attempt to influence the quality of life and the manifestation of menopausal syndrome with the help of lifestyle correction, diet modification and the use of minor biologically active substances. The aim was also to determine the features of the diet of women of reproductive age (to determine the excess and lack of nutrients) in order to create an algorithm for correcting the diet and preventing delayed risk factors.

Network Pharmacology and Molecular Docking Analysis of the Mechanism Underlying Yikunyin's Therapeutic Effect on Menopausal Syndrome.

Objective Yikunyin is an empirical prescription that exhibits good efficacy in the clinical treatment of menopausal syndrome; however, its underlying mechanism remains unclear. This study investigates the mechanism implicated in the therapeutic effect of Yikunyin by identifying its hub genes, central pathways, and key active ingredients. Method The active ingredients and targets of Yikunyin were obtained from the Traditional Chinese Medicine Systems Pharmacology database, whereas the targets related to menopausal syndrome were obtained from GeneCards, PharmGKB, Therapeutic Target Database (TTD), and Comparative Toxicogenomics Database (CTD). To reveal the pharmacological mechanism, the component-target and the intersecting protein-protein interaction (PPI) networks were constructed, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed. Finally, molecular docking was carried out to assess the strength of binding between the key active ingredients and key targets. Results A total of 418 targets and 121 active ingredients were identified in Yikunyin. The intersection of Yikunyin's 418 targets with the 2822 targets related to menopausal syndrome shows that there are 247 common targets that can be considered potential targets of Yikunyin in the treatment of menopausal syndrome. The topology analysis of the constructed PPI network conducted using the Cytoscape software shows that there are 15 hub genes implicated in the therapeutic effect of Yikunyin: AKT1, PRKCA, TLR9, CXCL10, PRKCD, PARP1, ABCB1, TP53, CAV1, MAPK8, PPARA, GRB2, EGFR, IL-6, and JAK2. Moreover, the key active components acting on these genes are paeoniflorin, luteolin, quercetin, beta-sitosterol, and kaempferol. GO and KEGG analyses indicate that Yikunyin can treat menopausal syndrome by regulating cellular response to chemical stress (GO:0062197), cellular response to oxidative stress (GO:0034599), phosphatase binding (GO:0019902), cytokine receptor binding (GO:0005126), PI3K-Akt signaling (hsa04151), lipid and atherosclerosis (hsa05417), and hepatitis B (hsa05161). Finally, the results of molecular docking suggest that the key active ingredients and key targets can bind well, with binding energies of less than −5 kJ/mol. Conclusion The research conducted herein reveals that Yikunyin treats menopausal syndrome by targeting AKT1 and IL-6 and by regulating the PI3K-Akt signaling pathway. Moreover, it provides a new idea for understanding the therapeutic effects of traditional Chinese medicines.

Ospemifene (Osphena)


 CADTH recommends that Osphena should be reimbursed by public drug plans for the treatment of postmenopausal women with moderate to severe dyspareunia and/or vaginal dryness, symptoms of vulvar and vaginal atrophy (VVA), a component of genitourinary syndrome of menopause, if certain conditions are met.
 Osphena should only be covered for patients who share the same characteristics as patients who are eligible for vaginal estrogen products that are currently reimbursed by public drug plans for the treatment of postmenopausal VVA.
 Osphena should only be reimbursed if it is not used with other estrogen therapies and if treatment with Osphena does not cost more than treatment with the least costly vaginal estrogen product currently reimbursed for postmenopausal VVA.

10 - Subjective outcomes in women with genitourinary syndrome of menopause treated for overactive bladder with vaginal estriol or prasterone

10 - Subjective outcomes in women with genitourinary syndrome of menopause treated for overactive bladder with vaginal estriol or prasterone

Description of Women's Knowledge about Menopause Complaints in Simbolon Village Padang Bolak District

Menopause is the last phase where a woman's menstrual bleeding stops completely. Menopausal syndrome is experienced by many women almost all over the world. In women who will experience menopause, they will experience symptoms or signs such as depressed mood, anxiety, decreased well-being and sleep disturbances. Factors causing menopause are caused by changes in the production of the hormones estrogen and progesterone, age at menarche, parity and contraception. The purpose of this study was to determine the knowledge of women about menopause complaints in Simbolon Village. This type of research is quantitative in nature using a descriptive research design. The population in this study were all women aged 45-55 years who lived in Simbolon Village totaling 56 people with a total sampling technique, where the entire population was used as the research sample. The results showed that the majority of respondents had sufficient knowledge about menopause complaints as many as 22 people (39.3%) and a minority of less knowledge as many as 16 people (28.6%). Respondents are expected to actively seek information about complaints during menopause.

Undifferentiated connective tissue dysplasia and knee osteoarthritis: clinical manifestations and the state of carbohydrate metabolism

Objective: to evaluate the impact of undifferentiated connective tissue dysplasia (CTD) on the clinical manifestations of primary osteoarthritis (OA) in postmenopausal women.Patients and methods. The case-control study included 38 postmenopausal women with primary knee OA, radiological stage II. The main group included 19 patients who met the criteria for CTD, the control group included 19 patients without CTD.Results and discussion. Patients in the control group had significantly higher values of body mass index, hip circumference and more pronounced clinical manifestations of menopausal syndrome. Patients in the control group had all clinical components and laboratory criteria of the metabolic syndrome, they also had greater limitations of joint function compared to patients of the main group. In patients with CTD pathogenetic mechanisms of development and progression of OA differ from the metabolic phenotype of OA.Conclusion. The dysplastic phenotype of OA develops in the absence of metabolic syndrome and with less functional impairment than the metabolic phenotype. The metabolic phenotype of OA is associated with insulin resistance, more pronounced functional and psycho-emotional disturbances.

Attitude and knowledge of women between 45 and 65 years on menopause syndrome at the university college hospital, Ibadan, Nigeria.

This research was designed to find out the attitude and knowledge of women between 45 and 65 years on menopause syndrome and its management. The study was conducted in University College Hospital located in Ibadan North Local Government of Oyo state. A self-designed forced-choice questionnaire was distributed to 100 women using random sampling technique. Furthermore, our study showed that most women view the onset of menopause positively and that few seek treatment. They report relatively low prevalence of menopausal symptoms, with the most significant being irregular menstrual cycles and increased blood pressure and urinary tract infections. Furthermore, our study revealed that 41% of the participants had no idea why their menstrual period stopped, while why 60% of the women had no idea what could be done to reduce menopausal symptoms. This study reveals a low level of awareness about menopausal syndrome and more should be done.

Prevalence of genitourinary syndrome of menopause in Japanese peri- and post-menopausal women: A cross-sectional online survey

ABSTRACT Introduction Genitourinary syndrome of menopause (GSM) is a symptom complex that occurs secondary to vulvovaginal atrophy. It is generally accepted that GSM is more prevalent in postmenopausal women, and that it can affect their quality of life (QOL). However, there is little data regarding GSM in Japan. Objective The aim of this survey was (i) to determine the prevalence of vulvovaginal symptoms of GSM among Japanese peri- and post-menopausal women and (ii) to examine whether sexual activity affected the prevalence of GSM. Methods We conducted an online survey of 4,134 Japanese women aged 40 – 79 years in the general population. In this primary study, we focused on vulvovaginal symptoms of GSM. GSM was defined as a condition characterized by presenting at least one vaginal symptom such as vulva dryness, vulva hurting, dryness during sexual activity, and dyspareunia using the vulvovaginal symptoms questionnaire. The correlations between age, sexual activity, and GSM were analyzed. Results The prevalence of GSM was 11.6%. The respondents who reported GSM were more likely to be younger. The most common symptom was vulva dryness (6.0%). Only 22.0% of respondents were currently sexually active. Sexual activity was significantly correlated with GSM (P<0.01). The participants aged their 40s – 60s who had sexual activity showed an age-dependent increase in the prevalence of GSM such as vulva dryness and hurting. The respondents aged their 70s who were sexually active reported less dyspareunia than the other ages. Conclusions The vulvovaginal symptoms of GSM were not found with high frequency in Japanese peri- and post-menopausal women. This primary study was conducted in limited areas of GSM. We are planning to analyze the features of GSM including urinary symptoms and QOL more comprehensively with our whole database. Disclosure Work supported by industry: yes, by KOBAYASHI Pharmaceutical Company Limited. A consultant, employee (part time or full time) or shareholder is among the authors (KOBAYASHI Pharmaceutical Company Limited).

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development.

Several formulations of intravaginal oestrogen are available for the treatment of genitourinary syndrome of menopause (GSM). These are safe and effective treatments for the symptoms of GSM. Licensed doses of intravaginal oestrogen do not elevate systemic estradiol levels above the normal postmenopausal range with long term use and there is no evidence of an increased risk of coronary heart disease, stroke, thromboembolism, colorectal cancer, endometrial cancer, breast cancer or breast cancer recurrence with their use. This should reassure both women and their healthcare professionals and should lead to more women receiving these localised, vaginally administered hormonal treatments. Available evidence also suggests a positive safety profile for transdermal testosterone treatment when delivered at physiological concentrations.

The study of the effectiveness of topical testosterone and estrogen for urinary tract symptoms of GSM

ABSTRACT Introduction Genitourinary Syndrome of Menopause (GSM) causes atrophic changes in the vulva and vagina due to a decrease in the amount of sex hormones with aging, causing unpleasant physical symptoms in the genital area. GSM symptoms are vulvar mucosa atrophy findings, vaginal dryness, lack of moisture during sexual intercourse, dyspareunia, frequent urination and urgency of urination, etc. Routine moisturizer use is recommended to prevent the progression of GSM symptoms, but the effect is insufficient from the perspective of mucosal improvement. In Europe and the United States, testosterone treatment is approved in addition to estrogen for GSM treatment, but it has not yet been approved in Japan. And its effect on GSM symptoms in Japanese women has not been investigated. Objective The aim of this study is to examine the efficacy and safety of topical treatment with testosterone and estrogen for GSM. Methods The survey was conducted from September 2019 to September 2020. Menopausal women with atrophy of the vulvar / vaginal mucosa and either urinary tract symptoms (frequent urination, urine leakage) or vaginal symptoms (vulvar pain, dryness) or sexual function symptoms (dyspareunia) was diagnosed as GSM and was included in the study. Patients with a history of surgery within 1 year and/or those with pelvic organ prolapse were excluded.An anatomical explanation of the vulva was given to the patient using a mirror during examination. Patients used topical hormone cream once daily for 1 month on the labia minora, external urethral meatus, and vestibule. The topical hormone cream contained 0.3% testosterone, 0.008% estradiol, and 0.003% ethinyl estradiol. The daily usage was 0.5 g.The effectiveness was evaluated as follows. The attending physician evaluated the vulvar moistness and the redness on a four-point scale. A Visual Analogue Scale (VAS) was used for contact pain. The Overactive bladder symptom score (OABSS) was used to assess urinary tract symptoms. All surveys were evaluated before and 1 month after use. Results The survey was conducted on 30 patients aged 48 to 75 years (mean 58.3 years, median 58.5 years). The vulvar moistness was significantly improved. The redness was improved in the labia minora. No major changes were observed in vestibular region. Contact pain was significantly improved. OABSS improved significantly.Itching of the vulva was observed in 10%. Abnormal bleeding was observed in 10%. Nipple discomfort was noted in 5%. All side effects were not serious. Conclusions Topical testosterone and estrogen are effective for GSM symptoms in Japanese women. Disclosure Work supported by industry: no.