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首页> 外文期刊>The journal of sexual medicine >Resistance and barriers to local estrogen therapy in women with atrophic vaginitis
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Resistance and barriers to local estrogen therapy in women with atrophic vaginitis

机译：萎缩性阴道炎妇女的抵抗力和对局部雌激素治疗的障碍

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Introduction. Vaginal atrophy results from a decrease in circulating estrogen and is experienced by approximately 50% of postmenopausal women. Its symptoms affect multiple dimensions of genitopelvic health, sexuality, and overall quality of life. Nonhormonal over-the-counter treatments may provide temporary symptom relief, but the condition is progressive, and hormonal treatment may be warranted. Aim.: The study aims to review the literature and discuss the impact of atrophic vaginitis and various treatment options, including the resistance and barriers to the use of local estrogen therapy for atrophic vaginitis. This article also aims to provide a greater awareness of the condition and the difficulties in communicating effectively with patients, and to provide strategies to help healthcare professionals acquire effective communication skills to initiate a candid dialogue with patients who may be suffering in silence and may benefit from therapy. Methods.: This review was based on peer-reviewed publications on the topic of atrophic vaginitis and local estrogen therapy identified from key word searches of PubMed, in addition to landmark studies/surveys and treatment guidelines/recommendations on menopause available in the literature and on the Internet. Main Outcome Measures.: The main outcomes are the impact of atrophic vaginitis and the various treatment options, including the resistance and barriers to the use of local estrogen therapy. Results.: Minimally absorbed local vaginal estrogen therapy enables administration of estrogen doses much lower than systemic doses used for vasomotor symptoms. Local therapy is also the first-line pharmacologic treatment recommended by the North American Menopause and International Menopause Societies. Despite treatment options, the sensitive nature of the condition and embarrassment may prohibit or limit many women from openly discussing symptoms with healthcare professionals. Many are hesitant to initiate hormonal treatment because of safety concerns. Conclusions.: Healthcare professionals should initiate and encourage frank and candid conversation about vaginal atrophy at annual visits and provide follow-up and treatment as needed.
机译：介绍。阴道萎缩是由循环雌激素减少引起的，绝经后妇女中约有50％经历过这种情况。其症状会影响生殖器盆腔健康，性行为和整体生活质量的多个方面。非激素类非处方药治疗可能会暂时缓解症状，但病情进展，可能需要激素治疗。目的：该研究旨在回顾文献并讨论萎缩性阴道炎的影响和各种治疗方案，包括对局部雌激素疗法治疗萎缩性阴道炎的抵抗力和障碍。本文还旨在提高人们对病情和与患者有效沟通的困难的认识，并提供策略以帮助医疗保健专业人员获得有效的沟通技巧，以与可能在沉默中遭受痛苦并可能从中受益的患者进行坦率的对话。治疗。方法：本综述是基于从PubMed的关键词检索中鉴定出的关于萎缩性阴道炎和局部雌激素治疗的同行评审出版物，此外还有有关文献和更年期的更年期研究/调查和治疗指南/建议。互联网。主要结果指标：主要结果是萎缩性阴道炎的影响和各种治疗选择，包括使用局部雌激素疗法的耐药性和障碍。结果：局部阴道雌激素疗法吸收最少，可使雌激素剂量远低于用于血管舒缩症状的全身剂量。局部治疗也是北美更年期和国际更年期协会推荐的一线药物治疗。尽管有治疗选择，但疾病的敏感性和尴尬性可能会阻止或限制许多女性与医护人员公开讨论症状。由于安全方面的考虑，许多人不愿开始激素治疗。结论：医护人员应在每年的就诊时就阴道萎缩进行坦率和坦率的交谈，并根据需要进行随访和治疗。

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