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. 2024 Nov 19;14(11):1504.
doi: 10.3390/life14111504.

Update on Genitourinary Syndrome of Menopause: A Scoping Review of a Tailored Treatment-Based Approach

Ilaria Cuccu  1 , Tullio Golia D'Augè  1 , Ilaria Firulli  1 , Emanuele De Angelis  1 , Giovanni Buzzaccarini  2 , Ottavia D'Oria  3   4 , Aris Raad Besharat  3   5 , Donatella Caserta  5 , Giorgio Bogani  6 , Ludovico Muzii  1 , Violante Di Donato  1 , Andrea Giannini  3   5
Affiliations

Update on Genitourinary Syndrome of Menopause: A Scoping Review of a Tailored Treatment-Based Approach

Ilaria Cuccu et al. Life (Basel). .

Abstract

This scoping review explores the therapeutic strategies available for managing genitourinary syndrome of menopause (GSM), a condition often underdiagnosed and undertreated despite significantly affecting women's quality of life. GSM results from decreased estrogen levels during menopause, leading to a range of symptoms including vulvovaginal atrophy and urinary tract issues.

Material and methods: we screened the literature for original studies with "menopause", "hormonal therapy", "vulvovaginal atrophy", "urinary incontinence", "urinary infections", "genitourinary syndrome".

Results: A total of 451 relevant articles were retrieved. After screening, 19 articles were included in this scoping review.

Discussion: First-line treatments typically include lubricants and moisturizers for short-term symptom relief, while unresolved or severe cases may warrant hormonal treatment. Topical hormonal treatments often have fewer side effects than systemic alternatives. Special attention is given to selective estrogen receptor modulators like ospemifene and steroid hormones like dehydroepiandrosterone (DHEA), which have shown beneficial effects on GSM symptoms. Moreover, innovative therapeutic approaches, such as laser treatment, are discussed in the context of their efficacy and accessibility. The safety of GSM hormonal therapy in women with a history or risk of cancer is also addressed, noting the need for more definitive research in this area. While there is a growing demand for tailored therapy, this scoping review emphasizes the importance of effective communication and counseling to allow women to make informed decisions about their treatment. Overall, this review underscores the need for increased awareness and further research into effective treatment options for GSM.

Keywords: DHEA; estrogen; genitourinary symptoms; hyaluronic acid; laser CO2; menopause; ospemifene; vulvovaginal atrophy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram results of the search strategy [28].
See this image and copyright information in PMC

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