TITLE:
Quality of Life before and after the Use of Vaginal Estriol in Postmenopausal Women with Lower Urinary Tract Symptoms
AUTHORS:
Silvia Veiga Teixeira de Freitas, Carlos Augusto Faria
KEYWORDS:
Post-Menopause, Lower Urinary Tract Symptoms, Estriol, Quality of Life
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.4,
April
8,
2020
ABSTRACT: Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antonio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King’s Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.42 ± 21.65; after: 40.81 ± 22.64), Incontinence Impact (before: 74.82 ± 27.66; after: 41.49 ± 30.83), Role Limitations (before: 43.20 ± 32.80; after: 21.09 ± 24.71), Physical Limitations (before: 38.09 ± 32.09; after: 14.62 ± 24.20), Social Limitations (before: 30.38 ± 28.75; after: 12.62 ± 19.85), Emotions (before: 43.31 ± 32.96; after: 20.18 ± 26.41), Sleep/Energy (before: 41.48 ± 37.74; after: 15.98 ± 23.31) and Severity Measures (before: 48.02 ± 24.68; after: 22.31 ± 20.25). All the differences were statistically significant (p-value ≤ 0.05). Conclusion: In the group of postmenopausal women with lower urinary tract symptoms included in the study, the use of topical vaginal estriol led to a decrease in the frequency of each symptom and the average scores in all domains of the KHQ, suggesting a positive effect on women’s QoL.