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Deconstructing the genitourinary syndrome of menopause.

Abstract：

:The concept of genitourinary syndrome of menopause (GSM) was recently introduced and has been gaining widespread use. While some justifications for its introduction are straightforward, others may be questionable. Numerous unspecific symptoms and signs were included in the definition of the syndrome, but the minimum number required for diagnosis was not established. While the GSM definition is designed to facilitate identifying vulvovaginal and urinary estrogen-deprivation-associated symptoms and signs, several concerns have evolved: (1) the syndrome may result in the underdiagnosis of vulvar and urinary pathology; and (2) serious conditions (e.g., high-grade squamous intraepithelial lesions of the vulva or vulvar intraepithelial neoplasia, differentiated type) may be missed while others may not receive appropriate treatment (e.g., lichen sclerosus, overactive bladder). In addition, the transformation of urogenital symptoms and signs into a syndrome may create an iatrogenization of menopause, which, consequently, can lead to demand for (and offer of) a panacea of treatments. This can be detrimental to the care of women who require focused therapy rather than global treatment addressing a variety of genitourinary conditions, not all of which even require any form of intervention. Women's needs may be better served by having a more precise urogenital diagnosis.

journal_name

Int Urogynecol J

journal_title

International urogynecology journal

authors

Vieira-Baptista P,Marchitelli C,Haefner HK,Donders G,Pérez-López F

doi

10.1007/s00192-017-3295-6

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

675-679

issue

5

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-017-3295-6

journal_volume

28

pub_type

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