(005) SYSTEMATIC REVIEW OF GENITOURINARY SYNDROME OF LACTATION: AN UNDERRECOGNIZED CONDITION IN POSTPARTUM HEALTH
Notice bibliographique
Résumé
Abstract Introduction The postpartum period presents substantial physiological changes, particularly during lactation, when the body is in a hyperprolactinaemia and hypoestrogenic state. This hormonal shift can lead to symptoms such as vaginal dryness, dyspareunia, urinary incontinence, and changes in sexual function, collectively referred to as the “Genitourinary Syndrome of Lactation” (GSL). Despite the prevalence of GSL, it remains underrecognized and thus underdiagnosed, potentially impacting maternal well-being and quality of life. Objective This systematic review seeks to consolidate the best available evidence on the prevalence of GSL and its associated symptoms, including vaginal dryness, vaginal atrophy, urinary issues, dyspareunia, and sexual dysfunction among postpartum lactating individuals. By assessing the prevalence and symptomatology of GSL, we aim to address its impact on postpartum health to guide potential management strategies. Methods The systematic review adhered to PRISMA guidelines. A comprehensive search of PubMed, Google Scholar, Scopus, ScienceDirect, and Cochrane Library databases was conducted through April 30, 2024. Search terms included combinations of “postpartum breastfeeding” and “genitourinary symptoms.” Eligibility was limited to studies on postpartum individuals assigned female at birth (AFAB) without congenital vulvar abnormalities, and in English. Studies including participants on exogenous hormone therapy, or with diagnosed hormonal disorders were excluded. Screening involved two independent reviewers, with conflicts resolved by a third. Data on patient demographics, study design, and GSL symptom presentation were extracted and analysed using R software. Study quality was assessed using the OCEBM Levels of Evidence and the JBI Critical Appraisal Checklist. Results Of the 1560 studies initially screened, 68 met inclusion criteria. This review highlighted a spectrum of GSL symptoms impacting pelvic floor integrity, vaginal health, and urinary function, with lactation-associated hypoestrogenism linked to decreased vaginal muscle tone, increased urinary urgency, and reduced sexual satisfaction. Among lactating individuals, the prevalence of vaginal atrophy and dryness was 63.9% and 53.6%, respectively. Meta-analyses revealed pooled prevalence estimates for dyspareunia at 3, 6, and 12 months postpartum to be 60.0%, 39.7%, and 28.5%, respectively. Additionally, the pooled odds ratios for dyspareunia at 3, 6, and 12 months postpartum among lactating individuals versus controls were 2.33, 2.24, and 1.45, respectively. The pooled mean Female Sexual Function Index (FSFI) score was found to be 21.5 (threshold for sexual dysfunction <26). Conclusions This systematic review highlights the significant impact of lactation-induced hypoestrogenism on genitourinary health. Understanding and clarifying GSL enhances clarity and precision in diagnosis and improves our understanding, management, and effective addressing of the condition, benefiting both healthcare providers and patients. Given the high burden and potential for long-term sequelae, further studies are warranted to develop standardized diagnostic criteria and treatment guidelines for GSL. Enhanced awareness and improved screening can lead to better identification and management of GSL, ultimately supporting postpartum women’s health and well-being. Disclosure No.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,042 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,006 |
| Bibliométrie | 0,010 | 0,011 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».