Amsterdam, 12 March, 2018 – A new clinical guide by the European Menopause and Andropause Society(EMAS) published in the journal Maturitas summarises the evidence on current management of pelvic organ prolapse in aging women after the menopause.
Nearly 50% of women will develop some form of pelvic organ prolapse (POP). It is expected that the burden of POP will escalate as women are living longer. The symptoms and severity of POP increase significantly across the menopausal transition, adversely affect quality of life and may be associated with urinary and fecal incontinence. Falling estrogen levels after the menopause may be involved in its etiology and hormone replacement therapy (HRT) may improve symptoms. However HRT is ineffective in its prevention or treatment. Physical therapies and surgery are therefore the mainstay of treatment.
POP should not be ignored because of the adverse effects on long term health and quality of life. Healthcare professionals in the field of menopause are in a key position to identify the problem, to characterize it, and either to manage it themselves or to refer women appropriately. Management may be challenging and requires advanced skills, particularly when surgery is required. Women need to be informed of the available treatments and their benefits and risks. The options range from weight loss, pelvic floor exercises and pessaries to reconstructive or obliterative surgery or laser treatments. Women should participate actively with their healthcare professional in making management decisions to ensure that the treatments are suitable for them.
EMAS recommends that all healthcare professionals dealing with menopause should be knowledgeable on POP. As surgery is challenging and requires urogynecological expertise, complex cases need to be referred to and managed by multidisciplinary referral centers. Clinical services should be able to offer up-to-date non- surgical and surgical options in order to satisfy treatment demands for this growing problem and to help women enjoy their later years.
The complete statement can be found in ‘Current management of pelvic organ prolapse in aging women: EMAS clinical guide by Andrea Giannini and others. DOI: https://doi.org/10.1016/j.maturitas.2018.02.004
It is published in Maturitas, published by Elsevier.