Genitourinary Symptoms of Menopause

Menopause atrophy

Genitourinary Symptoms of Menopause: Causes, Symptoms, and Treatment Options

Menopause is a natural transition, marking the end of the reproductive years. Along with the more commonly known symptoms like hot flashes and mood swings, menopause can bring about a range of genitourinary symptoms that impact quality of life. In this blog post, I will explore the causes, symptoms, and treatment options for genitourinary symptoms of menopause, with a particular focus on non-hormonal treatments and vaginal estradiol options. Please note that while hormone replacement therapy (HRT) is a treatment option, I will cover that in a separate post.

Genitourinary Symptoms of Menopause:

Causes:

Genitourinary symptoms during menopause are primarily due to the hormonal changes that occur as a body ceases its reproductive functions. The decline in estrogen levels plays a significant role in these symptoms.

1. Vaginal Dryness: A common symptom, it can cause discomfort, itching, and pain during sexual intercourse.
2. Vaginal Atrophy: Thinning and inflammation of the vaginal walls.
3. Dyspareunia: Painful sexual intercourse due to dryness and tissue changes.
4. Urinary Incontinence: Increased risk of urinary leakage.
5. Recurrent Urinary Tract Infections (UTIs): Changes in vaginal pH can make women more susceptible to UTIs.

Non-Hormonal Treatment Options:

1. Vaginal Lubricants and Moisturizers:
   • Lubricants:These provide immediate relief during sexual activity. Silicone based are preferred.
   • Moisturizers: Applied regularly, these help maintain vaginal moisture over time. This can include different moisturizing suppositories. Ex: Replens
   • Suppositories: Ex: Revaree
2. Pelvic Floor Exercises (Kegels):
   • Strengthening pelvic floor muscles can help improve urinary incontinence symptoms.
3. Laser Therapy:
   • Some women explore laser treatments to rejuvenate vaginal tissues and improve symptoms

Vaginal Estradiol Options

1. Vaginal Creams:

Vaginal estrogen (estradiol) creams are applied directly to the vaginal tissues. They help restore moisture, improve tissue health, and alleviate symptoms. Common brand names include Premarin and Estrace. They are typically inserted/applied 1-2 times per week for maintenance.

1. Vaginal Tablets:

Vaginal estradiol tablets are inserted into the vagina, where they gradually release and address dryness and atrophy. Vagifem is a well-known brand.

1. Vaginal Rings:

Vaginal estrogen rings, like Estring, are placed in the upper vagina and release estrogen continuously. It is kept in place and changed every 3 months. This option offers convenience and sustained relief

1. Vaginal Suppositories:

These estrogen suppositories are another localized treatment option to address genitourinary symptoms. Examples include Imvexxy

1. Oral medications:

There are certain medications which act as Selective Estrogen Receptor Modulators, to help increase circulating estrogen levels. A brand name example is Osphena, and it is indicated to help with painful intercourse.

Management and Monitoring:

It's essential to consult a healthcare provider before initiating any treatment. They can recommend the most suitable option based on individual symptoms and health considerations. Regular follow-ups are crucial to monitor progress and adjust treatment if necessary.