Effects Of Tibolone In The Treatment Of Menopausal Genitourinary Syndrome On Vaginal And Intestinal Flora

Objective（s）:Through the study of genitourinary symptoms and vaginal and intestinal flora in postmenopausal women,the distribution characteristics of vaginal and intestinal flora in women with genitourinary syndrome of menopause（GSM）and the effect of tibolone treatment of GSM on vaginal and intestinal flora were explored.Methods:1.From December 2021 to August 2022,32 GSM women were selected to attend the Gynecology Clinic of our hospital.Basic information,medical history and gynecological examination are performed.2.According to the pre-treatment group and post-treatment group（oral tibolone treatment for 6 months）,the clinical indicators before and after treatment were compared,and a total of 128 cases of vaginal and swabs were collected before and after treatment,and the structural characteristics of vaginal and intestinal microorganisms were analyzed by next-generation sequencing.Results:1.In the comparison of symptoms before and after GSM treatment,it was found that the incidence of vaginal dryness before treatment was highest（96.9%）,followed by dyspareunia（71.9%）,and the incidence of all symptoms decreased after treatment,especially in vaginal dryness（96.9%VS 18.8%）.2.Comparing the vaginal health index score and the modified Kupperman score before and after treatment,it was found that the vaginal elasticity,discharge amount,epithelial integrity,lubricity,and p H score after treatment were all improved compared with those before treatment.At the same time,the modified Kupperman score after treatment was lower than that before treatment,and the difference was statistically significant（P<0.05）.3.Comparing the biochemical indexes before and after treatment,it was found that the serum E₂level after treatment was higher than that before treatment,while the levels of TG,LH and FSH were lower than before treatment,and there were statistical differences（P<0.05）.4.Compared with the vaginal microbiome before treatment,it was found that the diversity of the vaginal microbiome after treatment was lower than that before treatment,but the relative abundance of lactobacillus was significantly higher than that before treatment,and there was a statistical difference（P<0.05）.5.Compared with before treatment,the diversity of intestinal flora after treatment was significantly increased,and the difference between the two was statistically significant（P<0.05）.Conclusion（s）:The treatment of GSM by tibolone can not only significantly relieve the symptoms of the reproductive tract and urinary tract of middle-aged and elderly women,but also change the structure of vaginal and intestinal flora.It is believed that microorganisms can play a certain role in maintaining the health of the female reproductive system,and they can be used as microbial indicators for judging efficacy in the future.