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Urogenital atrophy management (640)

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Early medical termination of pregnancy at home telephone call sheet. 

Urogenital atrophy describes changes to the tissue quality of the vulva, vagina, urethra and bladder trigone, secondary to reduced tissue estrogen exposure usually associated with the menopause. Symptoms are not necessarily controlled by systemic HRT, and local therapies are commonly needed.

Alternative terminologies include genitourinary syndrome of menopause and vulvovaginal atrophy. However, urogenital atrophy is preferred terminology used by the British Menopause Society (3).

Reported prevalence rates vary, with approximately 1 in 4 women having symptoms prior to menopause, 1 in 2 women after the menopause, and 70% of women affected in their 70s.
The impact of vaginal dryness on relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, with the condition often under reported and undertreated.

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Editorial Information

Last reviewed: 20/11/2024

Next review date: 30/11/2029

Author(s): Claire Higgins, Frances Lowrie.

Version: 2

Author email(s): claire.higgins3@nhs.scot, frances.lowrie3@nhs.scot.

Approved By: Gynaecology Clinical Governance Group

Reviewer name(s): Claire Higgins.

Document Id: 640

References

1. Menopause: diagnosis and management. NICE guideline [NG23]Published: 12November 2015 Last updated: 05 December 2019

2.Transvaginal laser therapy for urogenital atrophy, Interventional procedures guidance[IPG697]Published: 26 May 2021, NICE

3.BMS consensus statement, Urogenital Atrophy, March2024 https://thebms.org.uk/wp-content/uploads/2024/04/09-BMS-ConsensusStatement-Urogenital-atrophy-MARCH2024-A.pdf

4.McVicker L, Labeit AM, Coupland CAC, et al. Vaginal Estrogen Therapy Use andSurvival in Females With Breast Cancer. JAMA Oncol. 2024;10(1):103–108.doi:10.1001/jamaoncol.2023.4508

5.Cold S, Cold F, Jensen M-B, Cronin-Fenton D, Christiansen P, Ejlertsen B. Systemicor vaginal hormone therapy after early breast cancer: a Danish observational cohortstudy. J Natl Cancer Inst. 2022;114(10):1347-1354.

6.Use and procurement of additional lubricants for male and female condoms:WHO/UNFPA/FHI360 Advisory note,2012 WHO_RHR_12.33_eng.pdf;sequence=1.pdf

7.Edwards, D., & Panay, N. (2015). Treating vulvovaginal atrophy/genitourinarysyndrome of menopause: how important is vaginal lubricant and moisturizercomposition? Climacteric, 19(2), 151–161. https://doi.org/10.3109/13697137.2015.1124259

8.ospemifene (Senshio) (scottishmedicines.org.uk)

9.2024-09-sdt-part-3.pdf (publichealthscotland.scot)