UROGENITAL SYNDROME AND AGING
Aging is an integral part of women`s life and quite often this process is accompanied by the development of a condition called urogenital syndrome. Usually, urogenital syndrome symptoms appear after menopause. Urogenital syndrome treatment aims to relief and eliminate the symptoms, as well as improve the overall quality of women`s life during the post-menopausal period. More detailed information about this condition, its symptoms and urogenital syndrome treatment options is presented below.
This condition occurs when a patient experiences vaginal and urinary symptoms due to the lack of oestrogen. This is typically in a post-menopause state or after the surgical removal of one’s ovaries.Oestrogen receptors can be found in the pelvic floor muscles, urethra, bladder, and vagina. The lack of oestrogen can cause decreased elasticity, strength and atrophic changes of these organs.When this occurs, the amount of glycogen also decreases which in turn decreases Lactobacilli numbers. This causes a rise in pH level thus allowing organisms that may cause vaginal infections to thrive.It is crucial to seek for medical advice as vaginal or urine infections, tissue trauma from leakage and soiling, or the overuse of feminine products can all cause overlapping symptoms. The symptoms can vary widely and appropriate treatment takes into account each women’s symptoms, lifestyle and risk factors.
UROGENITAL SYNDROME SYMPTOMS
- Vaginal dryness
- Pain during sexual intercourse (dyspareunia)
- Pain when passing urine (dysuria)
- Superficial bleeding from mild trauma
- Unpleasant vaginal discharge due to secondary infections present
- Frequent strong sudden need to pass urine (urgency)
- Associated urinary leakage (urge incontinence)
- Recurrent urinary tract infections (RUTI)
UROGENITAL SYNDROME TREATMENT OPTIONS
Adherence to the vaginal walls may be enhanced after consistently using moisturizing gels formulated with a component of bio-adhesive. Treatment may start with vaginal insertion 3 times a week, reducing to 2 times a week after eight weeks. Relief may not be noticed until at least 6 weeks of treatment.
Remember to use aqueous-based lubricants to combat dryness during sexual activity as petroleum jelly-based products are not a satisfactory option. Note that even after adequate vaginal moisture has been re-established, additional lubrication may be required for coitus.
Long-term local oestrogen therapy is required for definitive management of the discomfort associated with atrophic changes in the vaginal tissues. Systemic oestrogen replacement provides only limited benefit in terms of reversing atrophic changes in the vaginal epithelium.
Women who require oestrogen replacement to manage symptoms of oestrogen deprivation such as vasomotor instability may also require concurrent local vaginal oestrogen. This is so that the patients can obtain adequate relief from vaginal dryness and lower urinary tract symptoms.
Various preparations are available, including:
- Conjugated oestrogen creams
- Low-dose estradiol vaginal tablets
- Slow-release vaginal rings
It is important to note that even though the choice of oestrogen delivery system will be governed to some degree by patient preference, there will still be a significant difference in the systemic absorption properties of the various agents.
The conjugated oestrogen creams are absorbed to a greater extent than vaginal tablets or rings. It’s also important to take into consideration where limitation of systemic oestrogen load is desirable or in women who are on concurrent systemic oestrogen replacement therapy.
DIAGNOSING UROGENITAL SYNDROME AND AGING
- History taking and physical exam: It’s helpful to ask focused questions regarding the more common conditions associated with urogenital atrophy in menopausal patients with pelvic or lower urinary tract complaints of any kind. To confirm diagnosis, routine pelvic exam will also be performed.
- Urinalysis and urine culture: Urine sample is examined for signs of infection, traces of blood or other abnormalities.
- Urine cytology: A test to search for abnormal cells in your urine.