Women with bothersome menopausal symptoms can seek treatment

Women who experience vaginal and urinary problems associated with menopause should seek help from their doctors, according to a new patient resource page from the JAMA journal.

Women with pre- and post-menopausal symptoms, as well as their doctors, need to remember that these common complaints are treatable in ways that can easily improve quality of life, writes Dr. Jill Jin.

“We created this resource based on a reader request, and I see many patients in my own practice with these complaints, so it’s highly relevant,” said Jin, an internist at Northwestern Memorial Hospital in Chicago, who wrote the one-page primer intended for patients.

The page discusses genitourinary syndrome of menopause, which used to be known as atrophic vaginitis. The new term was introduced in a 2016 review article in the American Journal of Obstetrics and Gynecology (bit.ly/2oDcPF4), which notes that the syndrome affects more than half of postmenopausal women.

“I see a wide variety of patients who look up health information online, and it’s useful to have reliable sources to direct them to when they have questions,” Jin told Reuters Health. “There’s a lot of false health information online, and journals such as JAMA are great places for concise, accurate information.”

The JAMA patient resource explains that estrogen levels drop during menopause, and the walls of the vagina become thin, dry and inflamed. The related symptoms of burning, irritation and urinary issues are common but can be more bothersome for some women than for others.

Doctors can recommend both hormonal and non-hormonal treatment options, such as over-the-counter lubricants and moisturizers or estrogen treatments administered by pill or through the skin.

“Women presume these symptoms are just signs of aging, but they can be corrected by talking to a gynecologist or urologist,” said Sardar Khan of Stony Brook University School of Medicine in New York, a co-author of the 2016 review.

Typically, doctors recommend trying vaginal estrogen first as a cream, tablet or ring inserted into the vagina. This provides estrogen to the vaginal area without circulating through the bloodstream first, which can lower the chance of health risks associated with hormonal treatments during menopause.

Women who have other symptoms associated with menopause, such as night sweats, hot flashes or other whole-body problems, may need to take estrogen treatments by a pill or skin patch, the patient resource notes. Women who take this type of estrogen should also take progesterone.

Khan and his co-authors reviewed additional treatments as well, including synthetic steroids, laser therapies, homeopathic remedies and lifestyle modifications. Importantly, early detection and individually-tailored treatment plans are key, the study authors wrote.

“Women should not suffer in silence,” Khan told Reuters Health. “The days are gone when we accept these symptoms as merely signs of aging.”

The JAMA patient page also suggests seeking additional information on the American Congress of Obstetricians and Gynecologists website about menopause (bit.ly/1Ml5Vcf ). The site features a comprehensive FAQ section about menopause, symptoms, osteoporosis, hormone therapy and healthy lifestyle advice.

Women should begin talking to their doctors about these symptoms in the perimenopause period and share any concerns they have, Khan said.

“Health providers should ask about menopause, quality of life, and pain routinely during visits,” he added. “I’ve found it’s often up to caregivers to make patients feel comfortable enough to open up and talk.”