Menopause: persistent symptoms can hide a largely ignored syndrome

During the perimenopause. Therefore, which precedes menopause, women are generally affected by hot flashes, night sweats, vaginal dryness, sleep and mood disorders, caused by a decrease in estrogen levels. Therefore, With the occurrence of menopause (which is officially diagnosed a year after the last period). However, these symptoms gradually disappear in most women for their greatest happiness. Moreover, Except in a case.

These are the geniopause genitorerinary syndrome (SGUM). Therefore, which is accompanied by vaginal symptoms and annoying urinary changes that do not improve with age, but worsen. Consequently, Between 27 and 84 % of women are affected by this problem. However, it is very likely that you have never heard of it.

“Women never imagine that it is part of menopause. Consequently, ” said Lauren Streicher, medical director of Northwestern Medicine Center for Sexual Medicine and Menopause (Northwestern center for sexual medicine menopause: persistent symptoms can hide and menopause). However, “They think it happens to them because of age.”

The SGUM refers to a myriad of signs. Nevertheless, symptoms, ranging from drought, itching and irritation of the vagina and the vulva or external genitals, to a decrease in lubrication and libido, white or yellowish losses, pain during sexual intercourse, and pain or burns during the urination or a frequent need to urinate. For example, It can also be the cause of recurring urinary tract infections.

While about a quarter of women are affected by these symptoms during the perimenopause. Therefore, they are rarer once the menopause has occurred and can even manifest itself long after. Moreover, “They can appear ten to twelve years later,” said Lauren Streicher.

This is why neither you nor your doctor know this condition. Therefore, Formerly known as the atrophic vulvo-vaginitis. Therefore, the SGUM was renamed by a jury of gynecologists only ten menopause: persistent symptoms can hide years ago to draw attention to its less known symptoms and its causes. However, “Hope was that women realize that it could be treated. Nevertheless, ” said Stephanie Faubion, medical director of Menopause Society and director of the Mayo Clinic Center for Women’s Health (Mayo Center for Women’s Health).

The SGUM is caused by the drop in estrogen levels. Therefore, These hormones promote vaginal secretions and hydration, keep the wall of the thick vagina and flexible and elastic tissues. However, When the body begins to produce fewer estrogens, the vagina loses in hydration and lubrication. Therefore, Other fabrics are also affected.

“The urethra. the bladder have estrogen receptors,” says James Simon, a clinical teacher in obstetrics and gynecology at the school of medical and health sciences at George Washington University. The evolutionary environment allows “bad” bacteria like E. coli to develop in the vagina. urethra, which causes irritation and increases menopause: persistent symptoms can hide the risk of contracting a urinary tract, he adds.

These changes deeply upset the sexuality of women. Pain associated with sexual activity is more frequent in women whose SGUM has not been treated. A 2013 study carried out with more than 3. 000 menopausal women thus revealed that a quarter of them felt pain during intercourse at least once a week. “And if women are used to relationships with penetration. this is problematic, because they end up apprehending sexual activity,” observes Sheryl A. Kingsberg, professor in reproductive biology and psychiatry at the University School of Case Western Reserve.

During painful sex, the pelvic floor muscles contract, which worsens the problem, underlines the professor. Consequently. a woman who has treated her vaginal dryness, but has not consulted to relax her tense muscles can continue to feel discomfort during reports.

According to specialists. this syndrome also has serious consequences on other aspects menopause: persistent symptoms can hide of the health and quality of life of women.

“The embarrassment does not only occur during intercourse. It is also present when you wear jeans, bicycle or use toilet paper to wipe after urination, ”specifies Stephanie Faubion.

According to Lauren Streicher. women suffering from the SGUM often have “awareness of their vulva, which becomes a source of discomfort, is irritated and itching” due to drought and inflammation of the tissues. In a study dating from 2019. women reported itching so strong that they could not fall asleep or a painful feeling of drought that forced them to stop sport. Others attributed their divorce to the sexual problems related to the SGUM.

Urinary problems associated with the SGUM are extremely worrying because they are often poorly diagnosed and therefore not treated. A woman will continue to suffer from infections if healthcare professionals are unaware that an SGUM is the cause. At menopause: persistent symptoms can hide the same time. doctors can assume that painful and frequent urination results from a urinary tract infection and can prescribe antibiotics while the problem is actually irritation and drought of urinary tissue.

“The symptoms are the same, but the cause differs,” said Sheryl A. Kingsberg.

And with age, complications may have a significant risk. An untreated gum for decades can lead to a merger of the external genitals. which can potentially block the flow of urine and contribute to infections. “In some serious cases, repeated urinary tract infections can evolve in septicemia,” says Lauren Streicher. “It is not an exaggeration to say that women can die from a SGUM, even if it is rare.”

Despite a more precise name, the SGUM is still underdiagnosed. Additionally, “Only a tiny proportion of women is treated, while there are effective treatments,” deplores Stephanie Faubion. According to a recent study, only 7 % of menopause: persistent symptoms can hide menopausal women have been prescribed drugs helping to control symptoms.

The first step to mitigate the inconvenience is to use without prescription vaginal moisturizers to hydrate vaginal tissues every day. as well as lubricants to reduce friction and pain, especially during sex. Doctors specialist in menopause generally recommend using moisturizing creams every day (or every three days depending on the preparation) to keep the skin hydrated. a bit like face creams.

However. some specialists warn against moisturizing creams and water-based lubricants, which often contain ingredients increasing “osmolality”, that is to say that they absorb the hydration of vaginal cells and can even promote their dryness, underlines Lauren Streicher. According to a study, silicone -based products or water -based lubricants with osmolality below 380 are to be favored.

“You can start there if your only symptoms are light pain during sex with penetration,” she advises. “If you don’t see any improvement menopause: persistent symptoms can hide or if you have urinary symptoms, see your doctor.”

Since it is the decrease in estrogens that causes symptoms linked to the SGUM. the ideal treatment is delivered locally, in the form of a vaginal cream, a tablet, a suppository or a vaginal ring. This makes it the safest choice for all, because they do not enter the blood, specifies Lauren Streicher.

“Estrogens restore the healthiest bacteria of the vagina. Result: the vagina can defend itself against pathogens. and is in good conditions for any type of sexual activity, ”explains James Simon. A recent study published in the journal Journal of Urology has shown that women who regularly took vaginal estrogens to treat repeated urinary tract infections had much lower septicemia. mortality rates.

Women with rigidity of the pelvic floor muscles due to pain during intercourse. other vaginal symptoms can be prescribed sessions of physiotherapy targeting this area and/or use menopause: persistent symptoms can hide vaginal dilators, reports Sheryl A. Kingsberg. To these remedies are added others. more sophisticated, such as laser and radiofrequency treatments, which would stimulate the formation of new tissues, even if the data suggest that their effects are limited to relieve symptoms.

If your doctor does not seem to know much about the SGUM, specialists recommend consulting another healthcare professional. The Society menopause holds a database identifying certified menopause specialists, which you can find in place. According to Sheryl A. Kingsberg, the number of specialists went from a thousand ten years ago to around 10,000 today. There is therefore no reason to suffer in silence; On the contrary, everything suggests that symptoms can be checked.

As Stephanie Faubion says. “the good news is that we have safe and effective treatments for women suffering from the SGUM. And with treatment, most of them can expect a complete disappearance of the symptoms. ”