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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-title><trans-title-group xml:lang="ru"><trans-title>Физиотерапия, бальнеология и реабилитация</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1681-3456</issn><issn publication-format="electronic">2413-2969</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">90013</article-id><article-id pub-id-type="doi">10.17816/1681-3456-2021-20-2-8</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Review</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Involutive changes in the vulvovaginal area</article-title><trans-title-group xml:lang="ru"><trans-title>Инволютивные изменения вульвовагинальной области</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0521-0333</contrib-id><name-alternatives><name xml:lang="en"><surname>Surkichin</surname><given-names>Sergei I.</given-names></name><name xml:lang="ru"><surname>Суркичин</surname><given-names>Сергей Иванович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Med.), Associate Professor</p></bio><bio xml:lang="ru"><p>к.м.н., доцент</p></bio><email>surkichinsi24@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5044-5265</contrib-id><contrib-id contrib-id-type="spin">1107-4372</contrib-id><name-alternatives><name xml:lang="en"><surname>Kruglova</surname><given-names>Larisa S.</given-names></name><name xml:lang="ru"><surname>Круглова</surname><given-names>Лариса Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>surkichinsi24@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4581-6295</contrib-id><contrib-id contrib-id-type="spin">6282-7435</contrib-id><name-alternatives><name xml:lang="en"><surname>Apolikhina</surname><given-names>Inna A.</given-names></name><name xml:lang="ru"><surname>Аполихина</surname><given-names>Инна Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><email>surkichinsi24@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1911-6743</contrib-id><name-alternatives><name xml:lang="en"><surname>Mayorov</surname><given-names>Roman Yu.</given-names></name><name xml:lang="ru"><surname>Майоров</surname><given-names>Роман Юрьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>surkichinsi24@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8317-0800</contrib-id><name-alternatives><name xml:lang="en"><surname>Avin</surname><given-names>Marika</given-names></name><name xml:lang="ru"><surname>Авин</surname><given-names>Марика</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>surkichinsi24@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Central State Medical Academy of Department of Presidential Affairs</institution></aff><aff><institution xml:lang="ru">Центральная государственная медицинская академия Управления делами Президента Российской Федерации</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov</institution></aff><aff><institution xml:lang="ru">Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени В.И. Кулакова</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Medical Center "Stolitsa"</institution></aff><aff><institution xml:lang="ru">Медицинский центр «Столица»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2021-03-15" publication-format="electronic"><day>15</day><month>03</month><year>2021</year></pub-date><volume>20</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>161</fpage><lpage>174</lpage><history><date date-type="received" iso-8601-date="2021-12-09"><day>09</day><month>12</month><year>2021</year></date><date date-type="accepted" iso-8601-date="2021-12-09"><day>09</day><month>12</month><year>2021</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2021, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2021, ООО "Эко-Вектор"</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">ООО "Эко-Вектор"</copyright-holder></permissions><self-uri xlink:href="https://rjpbr.com/1681-3456/article/view/90013">https://rjpbr.com/1681-3456/article/view/90013</self-uri><abstract xml:lang="en"><p>Involutional changes in the vulvovaginal area involve a series of transformations leading to vulvovaginal atrophy (VVA) during menopause. Signs and symptoms most often observed in this syndrome: vaginal dryness (54.4–100%), dyspareunia (17.6–77.6%), burning (2.0–56.9%), itching (7.8–56.6%) and dysuria (5.9–36.1%). Other complaints include deformity of the vulva, irritation, and recurrent bacterial infections of the urinary tract or vagina, and yeast infection. Vaginal dryness, dyspareunia and irritation are the symptoms that most affect a woman's quality of life.</p> <p>The article analyzes modern ideas about the genitourinary syndrome of menopause. The questions of the mechanisms of occurrence are considered, a description of the clinical picture is given. The issues of treatment of atrophy of the vulvovaginal region are discussed in detail, in particular, special attention is paid to physiotherapeutic methods of treatment.</p></abstract><trans-abstract xml:lang="ru"><p>Инволютивные изменения вульвовагинальной области подразумевают ряд трансформаций, приводящих к вульвовагинальной атрофии в период менопаузы. Признаки и симптомы, наиболее часто отмечаемые при данном синдроме, — сухость влагалища (54,4–100%), диспареуния (17,6–77,6%), жжение (2,0–56,9%), зуд (7,8–56,6%) и дизурия (5,9–36,1%). Другие жалобы включают деформацию вульвы, раздражение, а также рецидивирующие бактериальные инфекции мочевыводящих путей или влагалища, дрожжевую инфекцию. Сухость, диспареуния и раздражение влагалища — это симптомы, которые больше всего влияют на качество жизни женщины.</p> <p>В статье проанализированы современные представления о мочеполовом синдроме менопаузы, изучены механизмы его возникновения, описана клиническая картина. Подробно рассматриваются вопросы терапии атрофии вульвовагинальной области, особое внимание уделено физиотерапевтическим методам лечения.</p></trans-abstract><kwd-group xml:lang="en"><kwd>genitourinary syndrome of menopause</kwd><kwd>vulvovaginal atrophy</kwd><kwd>physiotherapy</kwd><kwd>photodynamic therapy</kwd><kwd>CO2 laser</kwd><kwd>erbium ER:YAG laser</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>мочеполовой синдром менопаузы</kwd><kwd>вульвовагинальная атрофия</kwd><kwd>физиотерапия</kwd><kwd>фотодинамическая терапия</kwd><kwd>CO2-лазер</kwd><kwd>эрбиевый ER:YAG-лазер</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Portman DJ, Gass ML, on behalf of the Vulvovaginal Atrophy Conference Panel: Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society. 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