Non-hormonal treatments for managing vulvovaginal atrophy/genitourinary syndrome of menopause

Abstract

The demand for non-hormonal therapies for vulvovaginal atrophy (VVA) is increasing due to an increasing number of patients surviving long term post cancer diagnosis, as well as increased public knowledge of the symptoms of menopause and availability of non-hormonal therapies. Treatment options are wide-ranging and encompass different formulations and methods of application. This review summarizes the key characteristics of the main forms of these therapies, as well as considering the current evidence for each of them and where future clinical studies should be directed. Care for VVA may be in primary care, or under gynecology or oncology. Further research requirements include the need for long-term data as well larger randomized controlled trials into alternatives where vaginal estrogen cannot be used as first-line treatment. Widespread education of health-care providers and patients on VVA and the impact on quality of life is urgently needed, as well as increased use of non-hormonal methods in routine clinical practice.

摘要

由于越来越多的患者在癌症诊断后长期存活, 以及公众对绝经症状的了解和非激素治疗的了解增加, 外阴阴道萎缩（VVA）非激素治疗的需求正在增加。治疗的选择范围十分广泛, 包括不同的配方和应用方法。这篇综述总结了这些疗法的主要形式的关键特征, 并考虑了每种疗法的现有证据以及未来临床研究的方向。VVA的护理可能在初级保健, 或在妇科或肿瘤科。进一步的研究要求包括需要长期数据以及更大规模的随机对照试验, 以寻找不能将阴道雌激素用作一线治疗的替代方案。迫切需要对医护人员和患者进行VVA及其对生活质量影响的广泛教育, 并在常规临床实践中增加非激素方法的使用。

Keywords:

• Vulvovaginal atrophy
• genitourinary syndrome of menopause
• moisturizer
• lubricant
• hyaluronic acid
• oxytocin
• laser
• ospemifene