Tinjauan Literatur: PATOGENESIS DAN TERAPI ATROFI VAGINA
DOI:
https://doi.org/10.21776/majalahkesehatan.2024.011.02.8Keywords:
atrofi vagina, estrogen, fitoestrogen, menopause, seksualitasAbstract
Atrofi vagina adalah masalah kesehatan yang paling banyak dialami oleh wanita menopause. Patogenesisnya berkorelasi dengan penurunan kadar hormon estrogen, yang mengakibatkan epitel vagina lebih tipis dengan proporsi sel-sel superfisial yang menurun. Pada dinding vagina terjadi penurunan jumlah serabut kolagen, penurunan massa otot polos dan penurunan vaskularisasi. Konsekuensi dari perubahan tersebut adalah dinding vagina mengalami penurunan dalam ukuran, elastis, lubrikasi, dan integritas lapisan mukosa. Gejala yang paling sering dialami adalah rasa nyeri pada vagina, yang akhirnya menyebabkan ketakutan untuk melakukan aktivitas seksual.Penanganan gejala atrofi vagina menjadi penting karena populasi wanita menopause yang besar dan akan terus meningkat. Tujuan penulisan tinjauan literatur adalah mengulas patogenesis atrofi vagina dan berbagai macam pilihan terapinya. Literatur didapatkan melalui pencarian pada Google Scholar dan PubMed database selama tahun 2022 dan dipilih terbitan 10 tahun terakhir, baik dalam Bahasa Indonesia maupun Bahasa Inggris. Kata kunci yang digunakan adalah menopause, atrofi vagina, patogenesis atrofi vagina, terapi atrofi vagina, fitoestrogen, Selective Estrogen Estrogen Receptors (SERM), dan terapi sulih hormon. Hasil menemukan bahwa sebagian besar kasus tidak terdiagnosis dan hanya sedikit yang mendapat terapi yang tepat. Sebagian besar wanita menopause mengobati sendiri gejala atrofi vagina yang dialami dengan obat-obat yang dijual bebas dan ada banyak kasus yang tidak diobati. Terapi utama atrofi vagina adalah hormon yang diberikan secara sistemik atau topikal. Salah satu terapi sistemik adalah SERM. Terapi topikal pilihannya sangat banyak yaitu fitoestrogen, asam hialuronat, pelembab, pelumas, kolostrum, vitamin, herbal, terapi laser dan radio frekuensi. Berbagai jenis metode terapi memiliki mekanisme kerja yang berbeda, sebagian besar terbukti efektif mampu memperbaiki struktur dan fisiologi vagina serta mampu mengurangi gejala atrofi vagina dan juga memperbaiki fungsi seksual.
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