Resumen

MONTERROSA-CASTRO, Alvaro  y  PORTELA-BUELVAS, Katherin. Manejo de la atrofia vulvovaginal posmenopáusica. Rev. chil. obstet. ginecol. [online]. 2014, vol.79, n.6, pp.489-501. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262014000600006.

Objective: To identify the available therapeutic proposals for the management of the atrophic vulvovaginitis or vulvovaginal atrophy in postmenopause (VVAP) or genitourinary syndrome of menopause. Methods: Thematic review without intervention in which there was included articles whose main criterion was treatment and management of the VVAP, obtained after search in the databases: Pubmed, Science Direct, Embase, Medline and Scielo. 2119 titles were considered appropriate, 136 were adjusted to the aim and in 87 relevants information was identified. Results: Different therapeutic strategies have shown effectiveness for the treatment of the VVAP. Changes in the lifestyle, as to avoid the smoking habit, to prevent the obesity, to do exercise and to practice sexual activity, could be beneficial. The vaginal moisturizers and lubricants are the first-line therapies for the improvement of the VVAP, the first ones are administered permanently and the last ones are used during the coitus. There is controversy about the importance of the D vitamin, soya isoflavones and different herbs. The local estrogen therapy is the most effective therapeutic and it always must be preferred in severe VVAP. It could be estriol, estradiol, conjugated estrogens or estrone. The ospemifene, a selective estrogen-receptor modulator, is approved for the VVAP. The TSECs are in research, few information exists about the effectiveness of DHEA and the results with the STEAR are good. Initial studies have indicated the benefits of the fractional CO2 laser. Conclusions: Different measures are appropriate to treat the VVAP, in order that the women preserve a healthy vagina and enjoy the sexual activity.

Palabras clave : Postmenopause; atrophic vaginitis; estrogen.

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