ABSTRACT
BACKGROUND: In 2012, the Board of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH) and the Board of Trustees of The North American Menopause Society (NAMS) acknowledged the need to review current terminology associated with genitourinary tract symptoms related to menopause. METHODS: The 2 societies cosponsored a terminology consensus conference, which was held in May 2013. RESULTS AND CONCLUSION: Members of the consensus conference agreed that the term genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing, and publicly acceptable term than vulvovaginal atrophy. GSM is defined as a collection of symptoms and signs associated with a decrease in estrogen and other sex steroids involving changes to the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra and bladder. The syndrome may include but is not limited to genital symptoms of dryness, burning, and irritation; sexual symptoms of lack of lubrication, discomfort or pain, and impaired function; and urinary symptoms of urgency, dysuria and recurrent urinary tract infections. Women may present with some or all of the signs and symptoms, which must be bothersome and should not be better accounted for by another diagnosis. The term was presented and discussed at the annual meeting of each society. The respective Boards of NAMS and ISSWSH formally endorsed the new terminology--genitourinary syndrome of menopause (GSM)--in 2014.
Subject(s)
Dysuria , Menopause , Terminology as Topic , Urinary Tract Infections , Vagina/pathology , Vaginal Diseases , Vulva/pathology , Vulvar Diseases , Atrophy , Estrogens/therapeutic use , Female , Humans , Reproductive Health , Sexual Behavior , Societies, Medical , Syndrome , United States , Women's HealthABSTRACT
BACKGROUND: In 2012, the Board of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH) and the Board of Trustees of The North American Menopause Society (NAMS) acknowledged the need to review current terminology associated with genitourinary tract symptoms related to menopause. METHODS: The two societies cosponsored a terminology consensus conference, which was held in May 2013. RESULTS AND CONCLUSION: Members of the consensus conference agreed that the term genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing, and publicly acceptable term than vulvovaginal atrophy. GSM is defined as a collection of symptoms and signs associated with a decrease in estrogen and other sex steroids involving changes to the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra and bladder. The syndrome may include but is not limited to genital symptoms of dryness, burning, and irritation; sexual symptoms of lack of lubrication, discomfort or pain, and impaired function; and urinary symptoms of urgency, dysuria and recurrent urinary tract infections. Women may present with some or all of the signs and symptoms, which must be bothersome and should not be better accounted for by another diagnosis. The term was presented and discussed at the annual meeting of each society. The respective Boards of NAMS and ISSWSH formally endorsed the new terminology - genitourinary syndrome of menopause (GSM) - in 2014.
Subject(s)
Menopause , Terminology as Topic , Vagina/pathology , Vulva/pathology , Atrophic Vaginitis/diagnosis , Atrophy , Female , Humans , Middle Aged , Reproductive Health , Societies, Medical , Vulvovaginitis/diagnosis , Women's HealthSubject(s)
Consensus , Hormone Replacement Therapy/methods , Hormone Replacement Therapy/standards , Female , Humans , MenopauseABSTRACT
The following Consensus Statement is endorsed by The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society.
Subject(s)
Consensus , Estrogen Replacement Therapy , Menopause , Breast Neoplasms , Coronary Disease/prevention & control , Estrogen Replacement Therapy/adverse effects , Estrogen Replacement Therapy/methods , Estrogens/administration & dosage , Estrogens/adverse effects , Female , Fractures, Bone/etiology , Fractures, Bone/prevention & control , Humans , Middle Aged , Osteoporosis, Postmenopausal/complications , Osteoporosis, Postmenopausal/prevention & control , Progestins/administration & dosage , Progestins/adverse effects , Quality of Life , Risk Factors , Stroke/epidemiology , Thromboembolism/epidemiologyABSTRACT
Today, 42% of Americans use alternative nonprescription therapies to treat medical conditions; 46% of nonprescription alternative use for principal medical conditions is done without consulting either a medical doctor or a nonphysician practitioner of alternative therapy. Many nontraditional alternatives are used to treat the hot flashes and somatic complaints of menopause, for which options such as hormone replacement therapy and other prescription and over-the-counter drugs are also available. To date, no one agent treats all menopausal symptoms as effectively as estrogen. Selective estrogen-receptor modulators can help prevent osteoporosis but do not relieve menopausal symptoms. However, some women are unwilling or unable to take hormone replacement therapy, and some decide to discontinue therapy. Evidence supporting the use of some nonprescription alternatives for conditions related to menopause is limited. Patients need to be aware of the potential for drug interactions when these alternative therapies are used concomitantly with prescription drugs. The current evidence to support use of hormone replacement therapy, selective estrogen-receptor modulators, and nontraditional alternatives is reviewed here.
Subject(s)
Hormone Replacement Therapy , Hot Flashes/prevention & control , Menopause , Nonprescription Drugs , Phytotherapy , Selective Estrogen Receptor Modulators , Female , HumansSubject(s)
Osteoporosis, Postmenopausal/prevention & control , Raloxifene Hydrochloride/therapeutic use , Selective Estrogen Receptor Modulators/therapeutic use , Bone Density/drug effects , Estrogen Replacement Therapy , Female , Humans , Raloxifene Hydrochloride/pharmacology , Selective Estrogen Receptor Modulators/pharmacology , Uterus/drug effectsABSTRACT
Two cases of nontraumatic fetal-maternal bleeding occurred in the second trimester. Both presented with mild, lower quadrant tenderness similar to round ligament pain, illustrating the potential for a misdiagnosis.
Subject(s)
Fetomaternal Transfusion/diagnosis , Pain/etiology , Adult , Diagnosis, Differential , Female , Fetomaternal Transfusion/complications , Fetomaternal Transfusion/drug therapy , Humans , Immunization, Passive , Immunoglobulins/administration & dosage , Pregnancy , Rh Isoimmunization/blood , Rh Isoimmunization/etiology , Rh Isoimmunization/prevention & control , Rho(D) Immune GlobulinABSTRACT
Acute vaginal bleeding secondary to uterine myomas can be a devastating event. We report the use of a combined therapeutic approach in a patient who presented with protracted bleeding of a myomatous uterus that was equivalent in size to a 38 week gestation. This patient's course was further complicated by her refusal of blood or blood products.
Subject(s)
Contraceptives, Oral, Synthetic/therapeutic use , Estrogens, Conjugated (USP)/therapeutic use , Leiomyoma/complications , Leuprolide/therapeutic use , Uterine Hemorrhage/therapy , Uterine Neoplasms/complications , Acute Disease , Adult , Anemia/etiology , Combined Modality Therapy , Contraceptives, Oral, Synthetic/administration & dosage , Drug Therapy, Combination , Female , Hematocrit , Humans , Injections, Subcutaneous , Leuprolide/administration & dosage , Preoperative Care/methods , Tampons, Surgical , Time Factors , Treatment Refusal , Uterine Hemorrhage/drug therapy , Uterine Hemorrhage/etiologySubject(s)
Menopause , Women's Health Services , Female , Humans , Middle Aged , Osteoporosis, Postmenopausal , Patient Education as TopicSubject(s)
Abdomen/surgery , Pelvis/physiopathology , Postoperative Complications , Uterine Prolapse/etiology , Abdomen/physiopathology , Aged , Female , Humans , PressureABSTRACT
Many women pass through menopause with no problems and no complaints. They should be encouraged to pursue healthy life-styles. For those who do experience difficulties or for those who are at risk for developing problems, the aforementioned treatment options can be considered. At this time, the benefits of HRT appear to outweigh the risks and offer substantial improvement in the quality of life to appropriately selected women. With the realization that women can expect to live one third of their lives after menopause, it becomes clear that it is important to discuss menopausal health issues with each women in order to make the postmenopausal period as enjoyable as possible.
