Symptoms Of Urogenital Atrophy Research Articles

Rational prescribing for postmenopausal urogenital complaints.

Urogenital complaints such as vaginal discomfort, dysuria, dyspareunia, recurrent lower urinary tract infections (UTIs) and urinary incontinence have been reported to affect more than 50% of postmenopausal women. These symptoms cause considerable suffering and an obvious reduction in quality of life for the afflicted individual, as well as being costly in economic terms for the health service. Urinary incontinence alone has been estimated to account for approximately 2% of health care costs in both the US and Sweden. Treatment with low potency estrogens given locally or orally has been shown to alleviate urgency, urge incontinence, frequency, nocturia and dysuria, but there is no conclusive evidence that estrogens alone improve or cure stress incontinence. Estrogen therapy has also been shown to cure or alleviate local urogenital atrophy symptoms, and to induce positive changes in the vaginal bacterial flora of postmenopausal women, which in turn reduces the risk of developing a UTI. There is little or no documentation to support the use of antibiotics in the treatment of local urogenital complaints such as pruritus, vaginal discomfort and discharge, or urinary incontinence in postmenopausal women. Antibiotics are, however, indicated for the treatment of UTIs, and in some cases for prophylactic treatment in women with recurrent UTIs. The number of women with urogenital complaints is expected to increase in the future, as the proportion of elderly women will be greater due to a higher life expectancy. Thus, in the future there will be an even greater need for simple, effective forms of treatment for large numbers of elderly women. Low potency estrogens given topically or orally have been shown to be an effective form of treatment for urogenital symptoms in postmenopausal women.

Hysterectomy increases the symptomatology of postmenopausal syndrome.

The purpose of our investigation was to verify whether or not women who have undergone hysterectomy react differently to the menopause compared with women who have not. The study was performed in a prospective documentation on 203 women, and the assessments of discomforts were provided by the patients themselves using questionnaires. For statistical purposes, the Mann-Whitney test and chi 2 test were used. In both groups of patients--with and without hysterectomy--a determination was made concerning the significance of differences in the degree of intensity of problems: breast tension (p < 0.05), muscle pains (p < 0.05), palpitations (p < 0.05) and dizziness (p < 0.01). Concerning the frequency of climacteric symptoms, a significant difference was noted for urogenital ailments. While only 29.6% of women who had not been operated on complained about discomfort caused by atrophy of the urogenital tract, the number of women with such discomfort who had had a hysterectomy was 42.6% (p < 0.01). In other words, women who underwent hysterectomy suffered more discomfort and showed frequent symptoms of urogenital atrophy.

Vaginal rings for continuous low-dose release of oestradiol in the treatment of urogenital atrophy

Silicone vaginal rings for the continuous release of 17β-oestradiol (E2) with 2 constant in vitro release rates were used for the treatment of symptoms of urogenital atrophy in 2 groups of post-menopausal women. The very low dose of 7 μg/24 h was found to alleviate atrophie symptoms effectively and to induce significant maturation of vaginal and urethral epithelium. After a brief initial peak, the serum levels of E2 over 3 mth of treatment remained close to the detection limit. The ‘undetectable’ E2 release pattern was reflected only in increased levels of oestrone sulphate. There was no evidence of a systemic metabolic response and patient acceptance of the method was excellent. Continuous low-dose release of E2 via vaginal rings consequently offers an alternative means of administering local oestrogen therapy which may be particularly suitable for geriatric patients.