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Laser versus topical estrogen for treatment of genitourinary syndrome. What does the research say?

Laser versus topical estrogen for treatment of genitourinary syndrome.  
What does the research say?

Estrogen cream has been used for many years to treat the genitourinary syndrome of menopause for many years with consistently good results.  Some women, however, do not tolerate estrogen hormones well or may have contraindications to hormone therapy. Some women are simply reluctant to use hormones of any kind.

According to the article published in The North American Menopause Society, vaginal laser therapy produces similar results as estrogen therapy with a 70-80% satisfaction rate at 6 months post-treatment.

In this study, 30 women had laser treatment while 32 had estrogen treatment.  At 6 months follow up 85% of patients in the laser treatment group reported feeling much better compared to 70% of patients in the estrogen group.  

Laser treatment for genitourinary syndrome of menopause may be a viable option for some patients but is typically not covered by insurance.  Additional studies in the future may change this.

A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial

Author: Marie Fidela Paraiso, Cecile Ferrando, Eric Sokol, et al

Publication: Menopause

Publisher: Wolters Kluwer Health, Inc.

Date: Jan 1, 2020

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Bleeding After Menopause, Why You Should Seek Help

Bleeding after menopause.
when should I get help?

Bleeding after menopause can be due to a myriad of reasons.  Often women find blood on wiping after using the bathroom. Knowing the exact source or cause of the bleeding can get tricky sometimes.  There are several reasons women may see spotting or a pink stain on wipes.  

Urinary tract infection – (UTI).  Often, this is accompanied by an increased urge to urinate, pain with urination, and feeling of incomplete emptying of the bladder after urinating.  

Urethral Curancle – this is a soft tissue that grows at the opening of the urethra and can cause similar symptoms as a urinary tract infection.  This tissue cause bleeding if it gets big enough and often requires removal by a urologist or urogynecologist.

Vaginal dryness – Vaginal dryness after menopause can cause vaginal spotting and even frank bleeding.  This happens when your body starts to produce less estrogen and typically not cause for alarm.

Thickened endometrium – This is the reason why women need to seek help if there is any bleeding after menopause.  Vaginal bleeding after menopause may be a sign of abnormal thickening and overgrowth of the endometrial lining. This can be a sign of endometrial cancer or ovarian cancer.  This is why the prompt evaluation by a gynecologist is recommended if there is any bleeding after menopause.  

Your doctor will perform a pelvic exam, obtain a pelvic ultrasound and recommend and endometrial biopsy.  If you are having any bleeding after menopause, request a consultation with a gynecologist for evaluation. 

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