更年期生殖泌尿症候群是停經後婦女常面對的健康問題，然而因缺乏對此疾病足夠的認識，許多女性認為這是老化過程自然出現的情形，加上臨床醫師缺乏主動關懷、重視此問題，使得更年期生殖泌尿症候群無法被正確診斷並給予治療，進一步造成女性反覆泌尿道感染、也影響與伴侶間的親密關係。更年期生殖泌尿症候群可依症狀嚴重程度，建議病人使用陰道潤滑劑、陰道雌激素乳膏、或雌激素補充療法。近年熱門的陰道雷射、乳酸桿菌補充療法因較缺乏足夠研究證據，臨床上可使用醫病共享決策與病人共同討論。本文詳盡整理更年期生殖泌尿症候群症狀、危險因子、診斷方式、非藥物與藥物治療，希望能增進此疾病的診斷率與治療率，提升更年期婦女的生活品質。
(台灣家醫誌 2023; 33: 59-71) DOI: 10.53106/168232812023063302001

關鍵詞：更年期生殖泌尿症候群、雌激素補充、陰道雷射、益生菌補充療法

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¹臺北市立聯合醫院和平婦幼院區家庭醫學科
²國立台灣大學醫學院附設醫院
³中山醫學大學醫學系
受理日期：111年11月3日 修改日期：112年1月31日 同意刊登：112年3月22日
通訊作者：吳雅萱 通訊地址：台北市中正區中華路二段33號5樓健檢中心 E-mail: b555786@gmail.com

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Genitourinary syndrome of menopause (GSM) is a common health problem faced by postmenopausal women. However, lack of knowledge about this syndrome prompts many women into regarding it as a normal condition of natural aging. Additionally, quite a few healthcare professionals do not proactively screen and pay attention to this problem, rendering GSM underdiagnosed and undertreated, leading to recurrent urinary tract infections affecting intimate
relationships with their partners. Depending on the severity of symptoms, treatment options of GSM include vaginal moisturizers, lubricants, vaginal estrogen creams, and systemic estrogen replacement therapy. Recently, laser therapies and the use of vaginal probiotics have gained popularity as treatment options. However, as the efficacy of these novel therapies remains in need of further clinical research and evidence, shared decision-making should be applied when discussing treatment with patients. Aiming at enhancing GSM diagnosis and treatment to improve the quality of life for postmenopausal women, this article examines in a comprehensive manner the clinical manifestations, risk factors, diagnosis methods, and pharmacologic treatments, and nonpharmacologic
interventions for GSM.
(Taiwan J Fam Med 2023; 33: 59-71) DOI: 10.53106/168232812023063302001

Key words: estrogen replacement therapy, genitourinary syndrome of menopause, probiotic therapy, vaginal laser therapy
 

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¹Department of Family Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
²College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
³Chung Shan Medical University, Taichung, Taiwan.
Received: November 3, 2022; Revised: January 31, 2023; Accepted: March 22, 2023.

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