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Danan ER, Diem S, Sowerby C, et al. Genitourinary Syndrome of Menopause: A Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2024 Jul. (Comparative Effectiveness Review, No. 272.)

Cover of Genitourinary Syndrome of Menopause: A Systematic Review

Genitourinary Syndrome of Menopause: A Systematic Review [Internet].

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Appendix AMethods

Search Strategy

Search Details and Sources

The search strategy was designed and conducted by an experienced medical librarian with input from the investigators. We applied the following limits or filters to the database searches:

  • Language. Only included publications written in English due to resource constraints.
  • Publication status. Only included peer-reviewed published studies.
  • Humans or organisms. Only included studies of human subjects, not animals.
  • Study design. The search was limited to randomized controlled trials (RCTs) and systematic reviews (SRs) of RCTs for KQ2 and KQ4; prospective observational studies with concurrent comparison group were also allowed for KQ1, KQ3, and KQ5. After review of the breadth of initially included studies, study design was further limited to trials with at least 20 individuals randomized per arm to identify the literature with the highest likelihood of having statistical power to detect an effect from our interventions of interest. We also excluded SRs, since none found covered sufficient studies/categories to reasonably replace individual studies. Instead, we used the SR reference lists to identify any missed primary studies.

We conducted a comprehensive literature search in January/February 2023. We searched the following databases:

  • Ovid MEDLINE(R) ALL <1946 to January 30, 2023> Date searched: January 30, 2023
  • Embase <1974 to February 01, 2023> Date searched: February 1, 2023
  • CINAHL Plus with Full Text

Database Search Strategies

Database: Ovid MEDLINE(R) ALL <1946 to January 30, 2023>

  1. climacteric/ or menopause/ or menopause, premature/ or postmenopause/ or primary ovarian insufficiency/ or (climacteric or estrogen-deficien* or hypoestrogeni* or menopaus* or postmenopaus* or post-menopaus* or primary ovarian insufficiency).ti,ab.
  2. ((genitourinary or genito-urinary) adj3 (symptom* or syndrome)).ti,ab.
  3. female urogenital diseases/ or vaginal diseases/ or vaginal discharge/ or vaginitis/ or atrophic vaginitis/ or vulvovaginitis/ or vulvitis/ or vulvodynia/ or (urogenital or vaginal atrophy or vaginal burning or vaginal discharge or vaginal dryness or vaginal itch* or vagina* pain* or vaginitis or vulvitis or vulvovaginitis or vulvovaginal atrophy).ti,ab. or (inflammation adj3 (vagin* or vulva*)).ti,ab.
  4. Dysuria/ or lower urinary tract symptoms/ or nocturia/ or urinary bladder, overactive/ or Urethral Diseases/ or Urethritis/ or urinary incontinence/ or urinary incontinence, urge/ or (dysuria or urinary symptom* or nocturia or overactive bladder or urethral caruncle or urethral prolapse or urethritis or incontinence or recurrent urinary tract infection*).ti,ab.
  5. dyspareunia/ or pelvic pain/ or sexual dysfunction, physiological/ or (dyspareunia or sexual dysfunction or pelvic pain).ti,ab.
  6. or/2-5
  7. 1 and
  8. exp Estrogens/ or Androgens/ or Estrogen replacement therapy/ or Testosterone/ or Dehydroepiandrosterone/ or Progesterone/ or exp Selective Estrogen Receptor Modulators/ or (estrogen* or oestrogen* or estradiol or oestradiol or bioidentical hormon* therap* or compound* hormon* therap* or androgens or ospemifene or phytoestrogens or prasterone or progesterone or selective estrogen receptor modulators or vaginal testosterone or intravaginal dehydroepiandrosterone or vaginal dehydroepiandrosterone or intravaginal DHEA or vaginal DHEA).ti,ab.
  9. Lasers, Gas/tu or Laser Therapy/ or (carbon dioxide laser or CO2 laser or erbium aluminum laser or erbium laser or Er:YAG laser or laser therap* or radiofrequency).ti,ab.
  10. Acupuncture Point/ or Acupuncture Therapy/ or drugs, chinese herbal/ or Yoga/ or (acupuncture or herbal supplement* or pelvic floor physical therap* or pelvic floor therap* or pelvic floor training or yoga).ti,ab.
  11. Lubricants/ or hyaluronic acid/ or “vaginal creams, foams, and jellies”/ or Oxytocin/ or Probiotics/ or ((vagina* or intravagin*) adj2 (cream* or dilator* or foam* or gel* or hyaluronic acid or insert or jelly or jellies or lubricant* or moisturizer* or oxytocin or probiotic* or vitamin D or vitamin E)).ti,ab.
  12. ((nonhormon* or non-hormon*) adj2 (therap* or treatment*)).ti,ab.
  13. or/8-12
  14. 6 and 13
  15. 7 or 14
  16. comment/ or editorial/ or letter/ or exp congress/ or clinical conference/ or consensus development conference/ or “Review”/
  17. (canine or canines or cow or cows or dog or dogs or mouse or mice or rabbit or rabbits or rat or rats).ti,ab.
  18. Penile Erection/ or Erectile Dysfunction/ or Prostatic Neoplasms/ or (erectile dysfunction or penile or prostate or prostatic).ti.
  19. or/16-18
  20. 15 not 19
  21. limit 20 to english language

Database: Embase <1974 to February 01, 2023>

  1. climacterium/ or early menopause/ or menopause/ or postmenopause/ or premature ovarian failure/ or (climacteri* or estrogen-deficien* or hypoestrogeni* or menopaus* or postmenopaus* or post-menopaus* or premature ovarian failure or primary ovarian insufficiency).ti,ab.
  2. ((genitourinary or genito-urinary) adj3 (symptom* or syndrome)).ti,ab.
  3. atrophic vaginitis/ or urogenital tract disease/ or vaginitis/ or vagina atrophy/ or vagina disease/ or “vagina discharge (disease)”/ or vaginal dryness/ or vagina pain/ or vulvovaginitis/ or vulvitis/ or vulvodynia/ or (urogenital symptoms or vaginal atrophy or vaginal burning or vaginal discharge or vaginal dryness or vaginal itch* or vagina* pain* or vaginitis or vulvitis or vulvovaginitis or vulvovaginal atrophy or (inflammation adj3 (vagin* or vulva*))).ti,ab.
  4. dysuria/ or lower urinary tract symptom/ or nocturia/ or overactive bladder/ or urethra disease/ or urethritis/ or urine incontinence/ or urge incontinence/ or (dysuria or urinary symptom* or nocturia or overactive bladder or urethral caruncle or urethral prolapse or urethritis or urge incontinence or recurrent urinary tract infection*).ti,ab.
  5. dyspareunia/ or female sexual dysfunction/ or pelvic pain/ or (dyspareunia or sexual dysfunction or pelvic pain).ti,ab.
  6. or/2-5
  7. androgen therapy/ or estrogen therapy/ or phytoestrogen/dt, va, po or prasterone/dt, va, po or progesterone/dt, th or selective estrogen receptor modulator/dt or testosterone/dt, th or (androgen* or bioidentical hormon* therap* or compound* hormon* therap* or estrogen* or oestrogen* or estradiol or oestradiol or intravaginal dehydroepiandrosterone or vaginal dehydroepiandrosterone or intravaginal DHEA or vaginal DHEA or ospemifene or phytoestrogen therap* or prasterone or progesterone therap* or selective estrogen receptor modulator or vaginal testosterone).ti,ab.
  8. carbon dioxide laser/ or erbium YAG laser/ or gas laser/ or laser therapy/ or radiofrequency therapy/ or (carbon dioxide laser or CO2 laser or erbium aluminum laser or erbium laser or Er:YAG laser or laser therap* or radiofrequency).ti,ab.
  9. acupuncture/ or acupuncture point/ or herbal medicine/ or yoga/ or (acupuncture or herbal supplement* or pelvic floor physical therap* or pelvic floor therap* or pelvic floor training or yoga).ti,ab.
  10. agents used intravaginally/ or hyaluronic acid/dt, va or lubricating agent/dt, va or oxytocin/dt, va or probiotic agent/dt, va or vitamin D/dt, va or ((vagina* or intravagin*) adj2 (cream* or dilator* or foam* or gel* or hyaluronic acid or insert or jelly or jellies or lubricant* or moisturizer* or oxytocin or probiotic* or vitamin D or vitamin E)).ti,ab.
  11. ((nonhormon* or non-hormon*) adj2 (therap* or treatment*)).ti,ab.
  12. or/7-11
  13. 1 and 6
  14. 6 and 12
  15. 13 or 14
  16. exp animal experiment/ or exp animal model/ or exp experimental animal/ or (cow or cows or canine or canines or dog or dogs or mouse or mice or rabbit or rabbits or rat or rats).ti,ab.
  17. erectile dysfunction/ or penis erection/ or exp prostate tumor/ or (erectile dysfunction or penile or prostate or prostatic).ti.
  18. 16 or 17
  19. 15 not 18
  20. limit 19 to (english language and embase)
  21. limit 20 to (books or chapter or conference abstract or conference paper or “conference review” or editorial or letter or note or “preprint (unpublished, non-peer reviewed)” or “review”)
  22. 20 not 21

Database: CINAHL Plus With Full Text <Searched February 01, 2023>

Interface – EBSCOhost Research Databases

  1. ((MH “Climacteric”) OR (MH “Menopause”) OR (MH “Menopause, Premature”) OR (MH “Postmenopause”)) OR ((climacteric or estrogen-deficien* or hypoestrogeni* or menopaus* or postmenopaus* or post-menopaus* or primary ovarian insufficiency or induced menopause or surgical menopause))
  2. (MH “Genitourinary Syndrome of Menopause”) OR ((genitourinary or genito-urinary) N3 (symptom* or syndrome))
  3. MH “Female Urogenital Diseases”) OR (MH “Vaginal Diseases”) OR (MH “Vaginal Discharge”) OR (MH “Vaginitis”) OR (MH “Vulvodynia”) OR (MH “Vulvovaginitis”) OR (MH “Vulvitis”) OR (MH “Dysuria”) OR ((MH “Overactive Bladder”) OR (MH “Urge Incontinence”) OR (MH “Urethral Diseases”) OR (MH “Urinary Tract Infections”) OR (MH “Urinary Incontinence”) OR (MH “Urethritis”) OR (MH “Dyspareunia”) OR (MH “Pelvic Pain”) OR (MH “Sexual Dysfunction, Female”) OR ((dysuria or urinary symptom* or nocturia or overactive bladder or urethral caruncle or urethral prolapse or urethritis or urge incontinence or recurrent urinary tract infection* OR dyspareunia or sexual dysfunction or pelvic pain OR urogenital or vaginal atrophy or vaginal burning or vaginal discharge or vaginal dryness or vaginal itch* or vagina* pain* or vaginitis or vulvitis or vulvovaginitis or vulvovaginal atrophy)) OR ((inflammation N3 (vagin* or vulva*)))
  4. 2 OR 3
  5. 1 AND 4
  6. ((MH “Androgens”) OR (MH “Estrogens”) OR (MH “Selective Estrogen Receptor Modulators+”) OR (MH “Dehydroepiandrosterone”) OR (MH “Estradiol”) OR (MH “Estriol”) OR (MH “Phytoestrogens”) OR (MH “Progesterone”) OR (MH “Testosterone”) OR (MH “Radiofrequency Therapy”) OR (MH “Laser Therapy”)) OR ((MH “Selective Estrogen Receptor Modulators+”) OR (MH “Dehydroepiandrosterone”) OR ((MH “Vaginal Creams, Foams and Jellies”) OR (MH “Hyaluronic Acid”) OR (MH “Oxytocin”) OR (MH “Probiotics”) OR (MH “Lubricants”)) OR ((MH “Acupuncture”) OR (MH “Acupuncture Points”) OR (MH “Drugs, Chinese Herbal”) OR (MH “Yoga”)) OR ((bioidentical hormon* therap* or compound* hormon* therap* or estrogen* or oestrogen* or estradiol or oestradiol or phytoestrogen* or progesterone or androgens or intravaginal dehydroepiandrosterone or vaginal dehydroepiandrosterone or intravaginal DHEA or vaginal DHEA or ospemifene or prasterone or selective estrogen receptor modulators or vaginal testosterone)) OR ((carbon dioxide laser or CO2 laser or erbium aluminum laser or erbium laser or Er:YAG laser or laser therap* or radiofrequency) OR (acupuncture or herbal supplement* or pelvic floor physical therap* or pelvic floor therap* or pelvic floor training or yoga)) OR ((vagina* or intravagin*) N2 (cream* or dilator* or foam* or gel* or hyaluronic acid or insert or jelly or jellies or lubricant* or moisturizer* or oxytocin or probiotic* or vitamin D or vitamin E)) OR ((nonhormon* or non-hormon*) N2 (therap* or treatment*)))
  7. 6 AND 4
  8. 5 OR 7
  9. (MM “Books”) OR (MH “Book Reviews”) OR (MH “Newsletters”) OR (MH “Theses and Dissertations”) OR (MH “News”) OR (MH “Teaching Materials”) OR (MH “Pamphlets”) OR (ZT “book”) or (ZT “book chapter”) or (ZT “book review”) or (ZT “ceu”) or (ZT “commentary”) or (ZT “conference paper”) or (ZT “conference proceeding”) or (ZT “dissertation”) or (ZT “doctoral dissertation”) or (ZT “editorial”) or (ZT “letter”) or (ZT “letter to the editor”) or (ZT “newspaper”) or (ZT “opinion”) or (ZT “pamphlet”) or (ZT “proceedings”)
  10. 8 NOT 9

Limiters - English Language; Peer Reviewed; Research Article; Exclude MEDLINE records; Sex: Female; Expanders - Apply equivalent subjects; Search modes - Boolean/Phrase

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