Genitourinary Syndrome of Menopause: Management Strategies for the Clinician

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Date: Dec. 2017
From: Mayo Clinic Proceedings(Vol. 92, Issue 12)
Publisher: Elsevier, Inc.
Document Type: Report
Length: 4,745 words
Lexile Measure: 2120L

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Abstract

Genitourinary syndrome of menopause (GSM), previously known as atrophic vaginitis or vulvovaginal atrophy, affects more than half of postmenopausal women. Caused by low estrogen levels after menopause, it results in bothersome symptoms, including vaginal dryness, itching, dyspareunia, urinary urgency and increased frequency, and urinary tract infections. Even though women with GSM can have sexual dysfunction that interferes with partner relationships, women are often embarrassed to seek treatment, and health care professionals do not always actively screen for GSM. As a result, GSM remains underdiagnosed and undertreated. Several effective treatments exist, but low-dose vaginal estrogen therapy is the criterion standard. It is effective and safe for most patients, but caution is suggested for survivors of hormone-sensitive cancers. Newer treatment options include selective estrogen receptor modulators, vaginal dehydroepiandrosterone, and laser therapy. Nonprescription treatments include vaginal lubricants, moisturizers, and dilators. Pelvic floor physical therapy may be indicated for some women with concomitant pelvic floor muscle dysfunction. Sex therapy may be helpful for women with sexual dysfunction. This concise review presents a practical approach to the evaluation and management of GSM for the primary care physician.

CME Activity

Target Audience: The target audience for Mayo Clinic Proceedings is primarily internal medicine physicians and other clinicians who wish to advance their current knowledge of clinical medicine and who wish to stay abreast of advances in medical research.

Statement of Need: General internists and primary care physicians must maintain an extensive knowledge base on a wide variety of topics covering all body systems as well as common and uncommon disorders. Mayo Clinic Proceedings aims to leverage the expertise of its authors to help physicians understand best practices in diagnosis and management of conditions encountered in the clinical setting.

Accreditation: In support of improving patient care, Mayo Clinic College of Medicine and Science is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Statement: Mayo Clinic College of Medicine and Science designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category I Credit(s)[TM]. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC Credit Statement: Successful completion of this CME activity, which includes participation in the evaluation component enables the participant to earn up to I MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit

Learning Objectives: On completion of this article, you should be able to (I) describe the signs and symptoms of genitourinary syndrome of menopause (GSM), (2) list the hormonal and nonhormonal treatment strategies for GSM, and (3) determine appropriate follow-up of patients with GSM.

Disclosures: As a provider accredited by ACCME, Mayo Clinic College...

Source Citation

Source Citation   

Gale Document Number: GALE|A522584363