About this Research Topic

Background

Aging is a universal, multifactorial process and constitutes an inevitable event, arousing interest in several areas worldwide. This process is not only influenced by time; psychological, social, biological, and functional changes also play a role in this process. One of the processes involving all of these changes is menopause, which is the result of ovarian failure, occurring either with aging or after medical treatments for various conditions. While menopause is usually a natural part of the aging process for women, the various sequelae of ovarian failure often require clinical management.

Genitourinary syndrome of menopause (GSM) is a new term for the condition previously described as vulvovaginal atrophy, atrophic vaginitis, and urogenital atrophy. GSM is a progressive hypoestrogenic condition with external genital, urological, and sexual implications. Despite the high prevalence of GSM, affecting 50-70% of postmenopausal women around the world, this condition remains significantly underdiagnosed. This can be partially attributed to the reluctance among women to seek help, accepting GSM as a regular feature of natural aging, and healthcare professionals’ lack of awareness regarding the syndrome. The condition is characterized by an extensive spectrum of symptoms and signs.

The majority of these symptoms can be attributed to the lack of estrogen that characterizes natural or iatrogenically-induced menopause. During this age, there is a decrease in circulating estrogen, resulting in anatomical changes that provoke the weakening of the vaginal epithelium and decrease in its collagen content, hyalinization, and elastin content. This thereby increases the connective tissue density and reduces the vascularity of the genitourinary tract, causing vaginal dryness, dyspareunia, reduced lubrication, and urinary symptoms. Additionally, GSM can significantly influence the quality of life (QOL) of the affected women, especially those who are sexually active.

Early detection and individually tailored treatment are paramount for improving quality of life and preventing the exacerbation of symptoms in women with this condition.

The discomfort associated with these changes can significantly impact general health and quality of life. The recommendation for the initial treatment of menopausal women with genitourinary symptoms is the local replacement of estrogen in low doses; however, in many women, the use of hormones is contraindicated. Many of them also have other comorbid diseases, such as breast cancer and thrombosis, which contraindicate hormonal therapy. For this reason, it is necessary to discover non-pharmacological treatment options. Physical methods, such as laser, radiofrequency, microneedling, and non-ablative, ablative, and micro-ablative forms have already been used. Studies with clinical evaluation, histopathology, electron microscopy, and immunohistochemistry have obtained satisfactory results in the skin's regenerative process using these procedures.

In this Research Topic, we welcome manuscripts on the following areas of interest:
• Etiology, pathophysiology and risk factors
• Clinical manifestations and evaluation
• Complementary exams
• Management of the disorder
• Hormonal treatments
• Non-hormonal treatments

Original Research articles, Case Reports, Clinical Trials, Mini Reviews, Opinion pieces, Perspectives, Reviews, Study Protocols and Systematic Reviews are all welcome as part of the collection.

We would like to ackowledge Ayane Cristine Alves Sarmento and Ana Paula Ferreira Costa as Coordinators of this Research Topic.

Keywords: genitourinary syndrome of menopause, vaginal atrophy, vaginal dryness, estrogen replacement therapy, menopause

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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