Vulvovaginal atrophy/genitourinary menopause syndrome (synonyms: Genitourinary Syndrome of Menopause (GMS), atrophy of the vulva; atrophy of the vagina, postmenopausal urethritis; atrophic colpitis; atrophic colpitis in postmenopause; atrophic postmenopausal colpitis; atrophic postmenopausal vaginitis; atrophic senile vaginitis; atrophic urethritis; atrophic vaginitis; atrophic vulvovaginitis; hormone deficiency urethritis; senile colpitis; postmenopausal urethritis; vaginal atrophy; senile colpitis; senile colpitis with vulvitis; senile urethritis; senile vaginal atrophy; senile vaginitis; other urethritis; vaginal atrophy; vaginal involution; vulvar atrophy; vulvitis due to estrogen deficiency; (ICD-10: N 95. 2: atrophic colpitis in postmenopause), (ICD-10: N90.5: atrophy of the vulva), (ICD-10: N 34.2: other urethritis) refers to changes in the skin of the vagina (vaginal) and vulva (entirety of the external primary sex organs) that may occur in women with declining estrogen levels.
The term genitourinary menopause syndrome was created in 2014 at an international consensus conference of the North American Menopause Society because the commonly used term vulvovaginal atrophy was inadequate to describe the variety of conditions associated with it. The term summarizes the atrophic changes that result from a hypoestrogenic state in the area of the vulva (labia majora/labia minora, clitoris/tickler, vestibulum vaginae/vaginal vestibule, introitus vaginae/vaginal entrance), vagina/vagina, urinary bladder, and urethra, associated with a sometimes significant impairment of the woman’s quality of life. There is currently no ICD-10 number for either term.
Frequency peak: The disease with the corresponding symptomatology occurs predominantly during the climacteric and postmenopause (time period that begins when menstruation has been absent for at least one year). However, it can occur at any age, when too little estrogen is produced due to hormonal disorders or hormonal imbalance. Physiologically, this occurs regularly in the puerperium, but it can also develop under hormonal contraception.
The prevalence of vulvovaginal atrophy/genital menopausal syndrome is >50% of postmenopausal women.Up to 80% of women suffer from vaginal dryness (vaginal dryness) after menopause.
Course and prognosis: The course is usually progressive and dependent on the time of estrogen deficit.The quality of life of those affected can be significantly reduced. In addition, it is a taboo subject, which the affected rarely or never discuss with their best friend or husband, but also not with the gynecologist, because they accept the problem as a given and age-related with corresponding problems that affect the partner relationship and sexuality.Unfortunately, the therapeutic options are limited. Moisturizers or lubricating creams usually help only slightly and in the short term, and the effectiveness of selective estrogen receptor modulators (SERM) is also currently not very widespread. Estrogen therapy, which is relatively effective, is often undesirable or even contraindicated (e.g., breast carcinoma/breast cancer, endometrial carcinoma/uterine cancer) and relatively often not sufficiently effective.Recently, fractionated CO2 laser therapy has been recommended as a particularly effective, uncomplicated therapy option with few side effects.(See also below Further therapy: conventional nonsurgical therapy methods).
