ABSTRACT
The most publicized medical concerns for menopausal women are the associated thinning of the bones, low bone density and osteoporosis, plus cardiovascular and cerebrovascular disease. A common complaint of menopausal women is vaginal dryness when intercourse is attempted. The altered pH and decreased numbers of lactobacilli can tip the microbiologic balance in the vagina, allowing an overgrowth of Gram-negative bacilli. The vaginal colonization with increased numbers of Gram-negative aerobes is the most important factor in the increased risk of urinary tract infections in postmenopausal women. The concentration of interleukin-17A has also recently been shown to be greatly increased in sera from postmenopausal women. This cytokine amplifies the immune response by inducing the local production of chemokines and cytokines, recruiting neutrophils and monocytes, augmenting the production of autoantibodies, and intensifying inflammation. Local adrenocorticoid creams or ointments are indicated if there is widespread inflammation or lichen sclerosus is present.
