Possibilities of Using Intravaginal Dehydroepiandrosterone in the Treatment of Genitourinary Syndrome in Postmenopausal Women

Aim. To analyze literature data on modern treatment options for urogenital disorders in postmenopausal women. Key points. Menopause is a natural condition of a woman associated with a decrease in the synthesis of sex hormones, which leads to a complex of genital and urinary symptoms known as genitourinary menopausal syndrome. During menopause and further into postmenopause, the levels of not only androgens and estrogens, but also their precursor dehydroepiandrosterone (DHEA) decrease. Currently, prasterone is registered in the Russian Federation — an exogenous, synthetic DHEA in the form of suppositories for intravaginal administration, intended for the treatment of dyspareunia as a symptom of vulvovaginal atrophy in postmenopausal women. In addition, it has demonstrated efficacy in the treatment of sexual dysfunction associated with atrophic changes and dyspareunia in postmenopause, as well as overactive bladder, nocturia and other urinary symptoms. DHEA does not cause the development of endometrial hyperplasia with intravaginal use. Conclusion. Women currently spend 30–40% of their lives in conditions of sex hormone deficiency. Local estrogens have demonstrated high efficiency in solving this problem. Quite a lot of experience has been accumulated in the use of DHEA intravaginally to relieve symptoms of genitourinary menopausal syndrome; it is also effective for the treatment of sexual dysfunction associated with menopause. Prasterone reduces the severity of subjective symptoms of overactive bladder, minimizes potential risks associated with estrogen-based therapy. High satisfaction of women with DHEA is noted. Keywords: vaginal atrophy, dehydroepiandrosterone, intracrinology, dyspareunia, genitourinary menopausal syndrome.