Genitourinary syndrome of menopause: Important aspects of the pathogenesis, diagnosis, and treatment: A review

Genitourinary syndrome of menopause (GSM) is a significant medical and social problem of the menopausal period, involving 10–90% of women older than 50 years. The high prevalence of GSM underscores the necessity for practitioners to remain informed about its pathogenesis, diagnosis, and treatment. New data indicate the need for practical work with patients who have a high risk of developing GSM or who already show its manifestations. The review includes data from international and Russian scientific papers on this topic, published over the past 10 years. A systematic analysis of data on the pathogenesis of GSM was conducted, characterizing the variety of urinary and gynecological symptoms and specific features that should be considered in the differential diagnosis with other diseases. GSM therapy includes pathogenetic treatment (menopausal hormone therapy, topical application of estrogen-containing drugs), exercise, giving up bad habits, normalization of body weight, and other interventions. The use of topical formulations containing estriol and lactobacilli is pathogenetically justified and is the main direction in both the treatment and prevention of recurrent GSM episodes. Modern medicine can effectively eliminate the symptoms of GSM and develop preventive measures that will improve the quality of life of a woman during the postmenopausal period.