Sustainability of vaginal estrogens for genitourinary syndrome of menopause – a systematic review

Abstract

Genitourinary syndrome of menopause (GSM) is a highly prevalent, not self-limiting condition displaying a major negative impact on sexual function and emotional well-being. Various non-hormonal and hormonal treatment options are available. Many women consider GSM treatment to be a short-term interval cure rather than a long-term or lifelong treatment. The aim of this systematic literature search was to assess the sustainability of vaginal estrogens for GSM treatment after treatment cessation. We found that objective GSM signs mostly deteriorated within approximately 4 weeks after vaginal estrogen treatment cessation, while vaginal estrogens had a more sustainable impact on subjective GSM symptoms up to 3–6 months. However, overall, scientific evidence on sustainability of vaginal estrogens was low. Thus, GSM treatment should not be considered a short-term interval cure but long-term therapy. Further studies in an internationally harmonized setting (Core Outcomes in Menopause [COMMA]) are needed.

绝经后泌尿生殖系统综合征患者阴道雌激素治疗的可持续性-一项系统综述 摘要

绝经后泌尿生殖系统综合征（GSM）是一种非常普遍的非自限性疾病, 对性功能和情感健康有很大的负面影响。有各种非激素和激素治疗选择。许多女性认为GSM治疗是一种短期间隔治疗, 而不是长期或终身治疗。该系统文献检索的目的是评估治疗停止后阴道雌激素对GSM治疗的可持续性。我们发现, 客观GSM症状大多在阴道雌激素治疗停止后约4周内恶化, 而阴道雌激素对主观GSM症状的影响更持久, 可达3-6个月。然而, 总体而言, 关于阴道雌激素可持续性的科学证据很少。因此, GSM治疗不应被视为短期间隔治愈, 而是长期治疗。需要在国际统一的背景下（绝经的关键结局[COMMA]）进行进一步的研究。

Keywords:

• Genitourinary syndrome of menopause
• sustainability
• vaginal estrogens
• systematic review

Acknowledgements

The authors are grateful for the support of secretary Lorella Gerber for helping to format the manuscript.

Potential conflict of interest

S.W., C.S., H.J. and C.G. declare no conflict of interest. P.S. has received financial support for an investigator-initiated trial from Medinova AG, Switzerland. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

The systematic literature search performed by the University library of Bern was funded by Medinova AG, Switzerland.