Day after day, the vagina is exposed to possible hostile attacks: after all, it is a constant connection to the outside world, where numerous potential pathogens also lurk. To protect the vagina and the associated sexual organs, nature has devised a sophisticated defense system. An important part of the protective process is the constantly produced … Vaginal Flora: Strong Balance
First, the doctor will take the medical history and ask exactly about the symptoms. During gynecological palpation, he may be able to palpate a uniform enlargement or bulbous changes. The diagnosis can almost always be made by ultrasound examination through the vagina. Rarely, a uteroscopy or laparoscopy is still necessary to bring clarity. What therapy … Myomas: Diagnosis and Therapy
Growths of smooth muscle cells in the uterus are the most common benign growths of the female reproductive organs. Still, quite little is known about why fibroids develop – female sex hormones probably play a role in their growth. Myomas in the uterus (uterine fibroids or uterus myomatosus) are common benign growths – about 15-20% … Myomas: Often Annoying, Almost Always Harmless
First, the doctor will take the medical history and ask exactly about the symptoms. During the gynecological palpation, he may be able to feel a (painful) enlargement of the ovary. By means of ultrasound examination through the vagina, he will see whether the cyst shows any abnormalities. Further examinations such as an ultrasound of the … Ovarian Cysts: Diagnosis and Treatment
Depending on the symptomatology, examinations concerning the bladder, vulva, and vagina and, to clarify menopausal symptoms, hormone status are useful and necessary. Laboratory parameters of the 1st order – obligatory laboratory examinations Bladder/urethra Urinalysis by test strip: A rapid test for nitrite detects nitrite-forming bacteria in the urine, if necessary. [Nitrate detection in urinary tract … Vulvovaginal Atrophy, Genital Menopause Syndrome: Test and Diagnosis
Therapeutic target More or less complete and long-term elimination of discomfort in the external genital area, vagina and bladder. Therapy recommendations The therapeutic measures are presented in detail in the following chapters. Bladder/Urethra (Urethra): Dysuria (difficult (painful) urination). Urinary incontinence (bladder weakness) Cystitis (inflammation of the bladder) Vulva/Vagina: Dyspareunia (pain during sexual intercourse). Vaginitis colpitis … Vulvovaginal Atrophy, Genital Menopause Syndrome: Drug Therapy
Mandatory medical device diagnostics. Vulva/Vagina Vaginal sonography (ultrasound examination using an ultrasound probe inserted into the vagina (sheath)) – to evaluate the genital organs. Optional medical device diagnostics – depending on the results of the medical history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification. Urethra/bladder Urodynamic diagnostics (including … Vulvovaginal Atrophy, Genital Menopause Syndrome: Diagnostic Tests
Surgical therapy is indicated for vulvovaginal atrophy and genitourinary menopause syndrome only for urinary incontinence (bladder weakness) after failure of other therapeutic attempts. s. Urinary incontinence: surgical therapy chapter.
To prevent vulvovaginal atrophy/genital menopause syndrome, attention must be paid to reducing individual risk factors. Behavioral risk factors Urethra/bladder Inadequate fluid intake – the better the bladder is “flushed,” the less likely it is to be inflamed Use of vaginal diaphragms (vaginal pessaries; mechanical means of contraception) and spermicides (sperm-killing agents) – this alters the … Vulvovaginal Atrophy, Genital Menopause Syndrome: Prevention
The following symptoms and complaints may indicate Vulvovaginal Atrophy/Genital Menopause Syndrome: Pathognomonic (indicative of a disease) Vaginal dryness Dyspareunia (pain during sexual intercourse). Main symptoms Vaginal dryness (100%) Dyspareunia (78%) Burning (57%) Pruritus (itching) (57%) Dysuria (difficult (painful) urination) (36%) Secondary symptoms Bleeding e.g. During gynecological examinations During intercourse Urge symptoms Urinary incontinence Infections Pollakiuria … Vulvovaginal Atrophy, Genital Menopause Syndrome: Symptoms, Complaints, Signs
Pathogenesis (disease development) The cause is estrogen deficiency. Estrogen receptors are reduced, atrophy occurs, and loss of function of the external genitalia, vagina, bladder, urethra, and pelvic floor develops; urogenital menopause syndrome develops. Most pronounced and regular, these changes occur during the climacteric/menopause (the time of the last menstrual period). Less pronounced in the puerperium … Vulvovaginal Atrophy, Genital Menopause Syndrome: Causes
General measures General measures are in the individual chapters: Urinary incontinence, cystitis (bladder infection), dyspareunia (pain during sexual intercourse), vaginitis colpitis (vaginitis) detailed. Conventional non-surgical therapy methods Conventional non-surgical therapeutic procedures are available for The overall problem of vulvovaginal atrophy, genitourinary menopause syndrome (vulva, vagina, bladder, urethra). As vaginal fractionated laser therapy (vulvovaginal laser therapy). … Vulvovaginal Atrophy, Genital Menopause Syndrome: Therapy
