Meta AnalysisID 7149

绝经生殖泌尿综合征的系统证据评价

CRD42023400684

KQ1: What is the effectiveness and harms of screening strategies to identify GSM in postmenopausal women? Does screening impact patient reported symptoms or improve quality of life? KQ2: What is the effectiveness and com

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Meta Analysis Id
7149
Evidence Id
15707
Core Evidence Id
15707
Source Meta Analysis Id
7134
Herb2 Meta Analysis Id
HBMA007134
Crd Id
CRD42023400684
Title
A Systematic Evidence Review on Genitourinary Syndrome of Menopause
Review Question
KQ1: What is the effectiveness and harms of screening strategies to identify GSM in postmenopausal women? Does screening impact patient reported symptoms or improve quality of life? KQ2: What is the effectiveness and comparative effectiveness of hormonal, non-hormonal, and energy-based interventions when used alone or in combination for treatment of GSM symptoms? Which treatments show improvement for which symptoms? KQ3: What are the harms (and comparative harms) of hormonal, non-hormonal, and energy-based interventions for GSM symptoms? KQ4: What is the appropriate follow-up interval to assess improvement, sustained improvement, or regression of symptoms of GSM in women treated with hormonal, non-hormonal, and energy-based interventions? KQ5: What is the effectiveness, comparative effectiveness, and harms of endometrial surveillance among women who have a uterus and are using hormonal therapy for GSM?
Study Type Included
KQ1, 3,&5: RCTs; prospective observational studies with concurrent control group KQ2&4: RCTs
Condition Being Studied
Genitourinary Syndrome of Menopause (GSM)
Participant
KQ1: Postmenopausal women KQ2-4: Postmenopausal women, premenopausal women in hypoestrogenic state, or gender diverse individuals on hormonal therapy, with one or more symptom of GSM. Excluding individuals with genitourinary symptoms for reasons other than GSM. KQ5: Patients with a uterus using hormonal therapy primarily for GSM symptoms. Excluding patients using hormonal therapy for reasons other than GSM. Excluding: men; children/adolescents; primary indication of endometriosis, dysmenorrhea, polycystic ovarian syndrome, vaginal candidiasis
Animal
Human Disease Modelled
Intervention
KQ1: Screening evaluations and/or questionnaires. Excluding physical exam. KQ2-4: Hormonal interventions (vaginal estrogen therapy, including vaginal cream, tablets, inserts or ring, ospemifene, intravaginal dehydroepiandrosterone [DHEA], oxytocin vaginal gel, vaginal testosterone; compounded and bioidentical hormonal therapies); Energy-based interventions (CO2 laser, Erbium: YAG, radio-frequency laser); Non-hormonal interventions (over-the-counter non-hormone vaginal lubricants and moisturizers, hyaluronic acid, herbal therapies/supplemental alternatives, phytoestrogens, vitamin D, vitamin E, probiotics, adjuvant, pelvic floor muscle training (PFMT) to treat vaginal or sexual symptoms of GSM) KQ5: Endometrial surveillance (ultrasound or biopsy) Excluding: menopausal hormone therapy if only for reasons other than GSM; laser therapy if for anatomic areas other than the vagina; pelvic floor physical therapy if for urinary incontinence; interventions not available in the U.S. (eg, estriol) and obsolete interventions (eg, 25 mcg estradiol tablets)
Comparator Control
KQ1: Usual care KQ2-3: Efficacy (placebo, inactive control, sham); Comparative Effectiveness (another hormonal, non-hormonal, or energy-based intervention) KQ4: Different durations of follow-up KQ5: Usual care; different type or level of surveillance
Main Outcome
KQ1: Diagnosis of GSM, misdiagnosis as another condition, progressing to unnecessary diagnostics (eg, vaginal or endometrial biopsy) KQ2&4: Change in most bothersome symptom(s) - Self-reported or clinician assessed - Genitourinary symptoms (ie, distress, bother or interference of genitourinary symptoms) - Other urinary symptoms (eg, discomfort or pain when urinating, overactive bladder, urge urinary incontinence) - Genital symptoms (eg, vulvovaginal dryness, vulvovaginal discomfort or irritation) - Sexual symptoms (eg, pain with sex, sexual function, sexual desire) - Psychological symptoms (eg, quality of life, depression, anxiety) KQ3&5: Safety, (systemic) adverse events, side effects of treatment - Self-reported or clinician assessed KQ5: Endometrial hyperplasia, endometrial cancer, post-menopausal bleeding Measures of effect Any
Outcome Measure
Additional Outcome
None Measures of effect Not applicable
Study Method
Systematic review
Keyword
Humans
Contact
Catherine Sowerby [email protected]
Organisational Affiliation
Minneapolis VA
Funding Source
This project was funded under Contract No. 75Q80120D00008 from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services Grant number(s) State the funder, grant or award number and the date of award Contract No. 75Q80120D00008
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
United States of America
Review Stage
Review Ongoing
First Submission Date
2023-02-28
Registration Date
2023-03-11
Anticipated Start Date
2022-12-30
Anticipated Completion Date
2024-01-12
Title Cn
绝经生殖泌尿综合征的系统证据评价
Title En
A Systematic Evidence Review on Genitourinary Syndrome of Menopause
Bilingual Status
complete