更年期生殖泌尿症候群綜論與臨床重要性

The Importance of Genitourinary Syndrome of Menopause: An Overview of Clinical Manifestation and Management

更年期生殖泌尿症候群是停經後婦女常面對的健康問題，然而因缺乏對此疾病足夠的認識，許多女性認為這是老化過程自然出現的情形，加上臨床醫師缺乏主動關懷、重視此問題，使得更年期生殖泌尿症候群無法被正確診斷並給予治療，進一步造成女性反覆泌尿道感染、也影響與伴侶間的親密關係。更年期生殖泌尿症候群可依症狀嚴重程度，建議病人使用陰道潤滑劑、陰道雌激素乳膏、或雌激素補充療法。近年熱門的陰道雷射、乳酸桿菌補充療法因較缺乏足夠研究證據，臨床上可使用醫病共享決策與病人共同討論。本文詳盡整理更年期生殖泌尿症候群症狀、危險因子、診斷方式、非藥物與藥物治療，希望能增進此疾病的診斷率與治療率，提升更年期婦女的生活品質。

 

Genitourinary syndrome of menopause (GSM) is a common health problem faced by postmenopausal women. However, lack of knowledge about this syndrome prompts many women into regarding it as a normal condition of natural aging. Additionally, quite a few healthcare professionals do not proactively screen and pay attention to this problem, rendering GSM underdiagnosed and undertreated, leading to recurrent urinary tract infections affecting intimate relationships with their partners. Depending on the severity of symptoms, treatment options of GSM include vaginal moisturizers, lubricants, vaginal estrogen creams, and systemic estrogen replacement therapy. Recently, laser therapies and the use of vaginal probiotics have gained popularity as treatment options. However, as the efficacy of these novel therapies remains in need of further clinical research and evidence, shared decision-making should be applied when discussing treatment with patients. Aiming at enhancing GSM diagnosis and treatment to improve the quality of life for postmenopausal women, this article examines in a comprehensive manner the clinical manifestations, risk factors, diagnosis methods, and pharmacologic treatments, and non-pharmacologic interventions for GSM.