The Menopausal Vulva and Vagina: Vestibulodynia or GSM and Treatment

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The presentation by the American Urogynecologic Society (AUGS) addresses the clinical manifestations and treatment options for hormone-mediated vestibulodynia (VVS) and Genitourinary Syndrome of Menopause (GSM). Dr. James A. Simon outlines the profound impact these conditions have on sexual function and emphasizes the importance of evidence-based treatment, including hormonal, nonhormonal, and energy-based therapies.<br /><br />Key takeaways include understanding the complex nature of the vulvovaginal health, particularly regarding misinformation spread through social media. The presentation also discusses the embryological development of female genitalia and how differing tissue origins contribute to their structural and functional characteristics.<br /><br />Various therapeutic interventions are examined, ranging from topical therapies like estradiol and testosterone compounds to oral medications such as anticonvulsants and SNRIs. Surgical and non-surgical treatments like vestibulectomy and pelvic floor therapy are suggested for individuals experiencing severe symptoms.<br /><br />The document also emphasizes the high incidence of GSM/VVA among postmenopausal women, noting its chronic and progressive nature, which significantly affects quality of life. It provides insights into the biochemical changes, like increased vaginal pH and estrogen receptor concentration differences, contributing to symptoms such as dryness, irritation, and dyspareunia.<br /><br />Furthermore, the guide covers the benefits of specific FDA-approved products, including estradiol creams, SERMs like ospemifene, and prasterone (DHEA). The presentation critiques new technologies like CO2 lasers and gives insight into ongoing clinical trials for various energy-based alternative therapies.<br /><br />The comprehensive exploration of these topics highlights the necessity of appropriate diagnosis and management to mitigate the adverse effects GSM/VVA has on urogenital health, sexuality, and relationships, advocating for awareness and effective treatment approaches to improve life quality for affected women.

Keywords

hormone-mediated vestibulodynia

Genitourinary Syndrome of Menopause

AUGS presentation

vulvovaginal health

treatment options

postmenopausal women

estradiol and testosterone

pelvic floor therapy

FDA-approved products

energy-based therapies