Menopausal genitourinary syndrome / vulvovaginal atrophy
- Vaginal moisturizers/lubricants for mild symptoms
- Low-dose vaginal estrogen is highly effective
- Vaginal DHEA or oral ospemifene are alternatives
- Local therapy has much lower systemic estrogen exposure
- Recurrent UTI may improve with vaginal estrogen
- Breast-cancer context needs individualized discussion
Use at a glance
- Vaginal moisturizers/lubricants for mild symptoms
Practical pearls
- Low-dose vaginal estrogen is highly effective
- Vaginal DHEA or oral ospemifene are alternatives
Treatment options
- Local therapy has much lower systemic estrogen exposure
- Breast-cancer context needs individualized discussion
Other practical pearls
- Recurrent UTI may improve with vaginal estrogen
Self-check
- How should GSM treatment be approached with breast-cancer history?
Individualized discussion. - How does local vaginal therapy compare with systemic estrogen exposure?
Much lower systemic exposure.
Drugs used for this (3)
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