eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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vol. 20
Review paper

Non-oestrogenic modalities to reverse urogenital aging

Simone Garzon
Vasso Apostolopoulos
Lily Stojanovska
2, 3
Federico Ferrari
Begum Aydogan Mathyk
Antonio Simone Laganà

Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
Institute for Health and Sport, Victoria University, Melbourne VIC, Australia
Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
Department of Obstetrics and Gynaecology, Spedali Civili of Brescia, Brescia, Italy
HCA Healthcare/University of South Florida Morsani College of Medicine GME Consortium, Brandon Regional Hospital, Brandon, FL, USA
Department of Obstetrics and Gynaecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
Menopause Rev 2021; 20(3): 140-147
Online publish date: 2021/10/11
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Urogenital aging is a common process affecting all women in the post-menopausal period of their life, and it is substantially due to oestrogen deprivation after ovarian function cessation. These changes can lead to a progressive, chronic, and complex association of symptoms identified as the genitourinary syndrome of menopause, which has a significant impact on quality of life. Genitourinary syndrome and urogenital aging do not resolve spontaneously and usually recur when treatment is stopped. Therefore, appropriate long-term management is of paramount importance, and local oestrogen is the most effective treatment to reverse urogenital aging and to improve symptoms of genitourinary syndrome as replacement therapy. In some women, topical oestrogen may be inconvenient, it may not achieve complete response, or it may be contra-indicated. Several non-hormonal therapies have been investigated, but few treatments have been reported as potentially able to reverse the urogenital aging process similarly to exogenous oestrogens. Laser seems the most promising, although further studies to define its safety and efficacy are mandatory. Vitamin D and E, and phytotherapy have returned conflicting results and require further confirmation. Lifestyle modifications, physiotherapy, and electrical stimulation represent inexpensive and applicable treatments that might slow urogenital aging. Among the hormonal non-oestrogenic therapies, the use of vaginal oxytocin and dehydroepiandrosterone have been found to be effective compared to placebo, as well as the use of oral ospemifene, which partially relieves vulvovaginal atrophy.

urogenital aging, genitourinary syndrome, non-hormonal therapy, vulvovaginal atrophy

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