Urogenital atrophy

Menopause is the permanent cessation of menses following the loss of ovarian follicular activity. Perimenopause is the period immediately prior to the menopause and the first year after menopause. Indications of postmenopausal hormone therapy include the short-term treatment of menopausal symptoms (i.e., hot flushes, night sweats, and urogenital atrophy). 

Other symptoms include vaginal dryness, dyspareunia, urogenital atrophy, sleep disturbances, sexual dysfunction, and impaired concentration and memory. 

Robinson and Cardozo (2003) concluded saying that the long-term effects of SERMs on the urogenital tract remain to be determined, and there are few data on the effects of these drugs on UI and urogenital atrophy. 

Local treatment should be offered to all women, especially those not receiving hormone treatment. Urogenital atrophy and vaginal dryness is frequent, but women have difficulties in expressing these symptoms, which is why the clinician should address this issue systematically. 

The novel SERMs, which include bazedoxifene and ospemifene (also known as deaminohydroxy-toremifene), are being investigated for the prevention and treatment of osteoporosis in post-menopausal women in phase III clinical trials [151,165]. The non-steroidal SERM lasofoxifene (CP-336156) [151], currently under consideration by the Food and Drug Administration for both prevention of osteoporosis and urogenital atrophy, may have potential for... 

The four most common symptoms associated with menopause are vasomotor disorders, or hot flashes urogenital atrophy osteoporosis and psychological disturbances. A varying proportion of women may have one or more of these symptoms. 

Bachmann G. Estradiol-releasing vaginal ring delivery system for urogenital atrophy. Experience over the past decade. I Reprod Med 1998 43(ll) 991-8. 

Cardozo, L., Bachmann, G., McClish, D., Fonda, D., and Birgerson, L. (1998), Metaanalysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women Second report of the Hormones and Urogenital Therapy Committee, Obstet. Gynecol, 92,722-727. 

When the efficacy of a vaginal ring, which delivers a continuous low dose of estradiol, was compared with a vaginal cream, both formulations were found to be equally effective and safe in the treatment of postmenopausal women with urogenital atrophy symptoms. ... 

Barentsen, R. Peter, H. Van de Weijer, H. Schram, J. Continuous low dose esradiol released from a vaginal ring vs estriol vaginal cream for urogenital atrophy. Eur. J. Ob. Gyn. Rep. Biol. 1997, 71, 73-80. 

Casper, F. Petri, E. Local treatment of urogenital atrophy with an estradiol-releasing vaginl ring a comparative and a placebo-controlled multicenter study. Int. Urogynecol. J. 1999,10, 171-176. 

Henriksson, L. Stjernquist, M. Boquist, L. Alander, U. Selinus, I. A comparative multicenter study of the effects of continuous low-dose estradiol released from a new vaginal ring versus estriol vaginal pessaries in postmenopausal women with symptoms and signs of urogenital atrophy. Am. J. Obstet. Gyn. 1994, 171, 624—632. 

Secondary amenorrhea Normal development of secondary sex characteristics, signs of urogenital atrophy... 

Bachmann GA. A new option for managing urogenital atrophy in postmenopausal women. Cont Obstet Gynecol 1997 42 13-28. 

The established benefits of estrogen therapy in postmenopausal women include amelioration of vasomotor symptoms and the prevention of bone fractures and urogenital atrophy. 

Ospemifene is another SERM that is currently in Phase III clinical trials for the treatment of postmenopausal osteoporosis and urogenital atrophy (150). As a metabolite of toremifene, it also is under evaluation as an effective treatment for breast cancer. In addition... 

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