Post-Menopausal and Sexuality Issues in the Maturing and Older Adult

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and management. American Journal of Obstetrics and Gynecology, 215(6), 704–711.
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Kim, H.-K., Kang, S.-Y., Chung, Y.-J., Kim, J.-H., & Kim, M.-R. (2015). The Recent Review of the
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menopause. Climacteric, 18(sup1), 23–29. https://doi.org/10.3109/13697137.2015.1079100
(http Sari Capilouto (Instructor)
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LaKeeshia,
I also found pelvic floor therapy to be a new topic when I first saw this video. Since then, I have
asked around to various PTs, and none have any experience (could be because we are in LTC).
You are correct that the use of low-dose vaginal estrogen treatments may help to alleviate
symptoms of GSM. I will say that I have prescribed estrogen therapy for chronic UTI in some of
my residents, and it is successful.
Lakeeshia or Peers – How does low-dose estrogen work, and what specific symptoms
may it help alleviate? That is, what is the mode of action that allows it to resolve the
symptoms of the patient?
Dr. Capilouto
(https://
Shalom Oyinade Adenekan
(https://chamberlain.instructure.com/courses/91626/users/142665)
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Menopausal and Sexuality Issues

How does low-dose estrogen work, and what specific symptoms may it help alleviate?
That is, what is the mode of action that allows it to resolve the symptoms of the patient?

GSM is caused by lack of estrogen and hence the administration of low-dose estrogen increases the availability of estrogen and thus relieves symptoms such as vaginal burning, vaginal discharge, burning with urination, and particularly recurrent urinary tract infections. Low levels of estrogen are linked to recurrent urinary tract infections (Ferrante et al., 2021). This is because estrogen stimulates the bladder to produce natural antimicrobial substances (Stanton et al., 2020). Estrogen also strengthens the urinary tract tissue as it closes the gaps between cells in the bladder lining. By closing the gaps, the hormone makes it difficult for bacteria to enter the deeper layers of the bladder and hence preventing urinary tract infections. The study by Ferrante et al (2021) also shows that estrogen prevents the shedding of bladder cells and this further prevents bacteria from entering the bladder. These are mechanisms through which that estrogen effectively treats GSM symptoms such as urinary tract infections that may be characterized by symptoms such as vaginal burning, vaginal discharge, and burning during urination.

References

Ferrante, K. L., Wasenda, E. J., Jung, C. E., Adams-Piper, E. R., & Lukacz, E. S. (2021). Vaginal estrogen for the prevention of recurrent urinary tract infection in postmenopausal women: a randomized clinical trial. Female pelvic medicine & reconstructive surgery, 27(2), 112-117.

Stanton, A., Mowbray, C., Lanz, M., Brown, K., Hilton, P., Tyson-Capper, A., … & Hall, J. (2020). Topical estrogen treatment augments the vaginal response to Escherichia coli flagellin. Scientific reports, 10(1), 1-11.