Turkish Journal of Geriatrics 2000 , Vol 3, Issue 3
GYNECOLOGIC PROBLEMS AND THE ELDERLY WOMEN
Timur GÜRGAN, Z. Selçuk TUNCER
Hacettepe Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı Ankara Since the life expectancy is increasing, the elderly population is growing in our society. Today the elderly population is the largest contributor to illness and human need. The most common gynecologic problems observed in elderly women population are gynecologic cancers, vulvar dystrophy and genitourinary atrophy. Gynecologic cancers approximately constitute 1/5 of all cancers in women. Endometrial cancer is the most common type of gynecologic cancer. Life time risk for endometrial cancer is 2%. The majority of cases are observed in postmenopausal elderly women. Although no effective screening method exists, most cases can be diagnosed in stage I due to early symptom of vaginal bleeding. The primary method of treatment is surgery. In high risk cases adjuvant radiotherapy or chemotherapy are administered. The prognosis in general is quite good. Pruritis vulva due to vulvar dystrophy is usually seen in elderly women. Histologic types are lichen sclerosus and squamous cell hyperplasia. Potent steroids such as clobetazol are used in treatment of these pathologies. Superficial vulvectomy is reserved for refractory cases. Estrogen deprivation in the postmenopausal period results in atrophy of genitourinary epithelium. Atrophy of genital structures may result in vaginal bleeding or stress incontinence. Estrogen replacement therapy has a role in prevention and treatment of these pathologies. Keywords : Endometrial cancer, Vulvar dystrophy, Lichensclerosus, Genitourinary atrophy, Estrogen