<?xml version="1.0" encoding="ISO-8859-1"?><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">
<front>
<journal-meta>
<journal-id>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152018000200071</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Envejecimiento del Sistema Urogenital y Disfunción Sexual Femenina]]></article-title>
<article-title xml:lang="en"><![CDATA[Aging of the Urogenital System and Female Sexual Dysfunction]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Chaves]]></surname>
<given-names><![CDATA[Daniela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez Campos]]></surname>
<given-names><![CDATA[Hazel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>35</volume>
<numero>2</numero>
<fpage>71</fpage>
<lpage>78</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152018000200071&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152018000200071&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152018000200071&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El sistema genitourinario presenta una serie de cambios micro y macroanatómicos desde el nacimiento, pasando por la pubertad, período reproductivo y por último con la menopausia, en la cual, se desarrolla un conjunto de síntomas sistémicos que incluyen los vasomotores, del sueño, cognitivos, del estado de ánimo y cambios sexuales, asociados a la presencia de disminución de la lubricación, estrechamiento y distensibilidad vaginal, atrofia vaginal, entre otros, que llevan a presentar una clínica de dispareunia, prurito, resequedad, además de síntomas urinarios. Su examinación conlleva la realización de una historia clínica, examen físico y ginecológico. Para confirmar los cambios se puede hacer una medición de pH y una citología para determinar un índice de maduración vaginal. Cuando estos síntomas se asocian a angustia y molestia se puede estar ante un caso de disfunción sexual, del cual se conocen factores de riesgo para su presencia como la edad como tal, problemas de pareja, estado de salud, autoestima, entre otros. Es por esto que a razón del tratamiento es importante hacer un abordaje interdisciplinario.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The genitourinary system presents a series of micro and macroanatomical changes from birth, through puberty, reproductive period and finally with menopause, in which a set of systemic symptoms are developed, including vasomotor, sleep, cognitive, mood and sexual changes, associated with the presence of decreased lubrication, narrowing and vaginal distensibility, vaginal atrophy, among others, leading to clinical symptoms of dyspareunia, pruritus, dryness, and urinary symptoms. Its examination involves the realization of a clinical history, physical and gynecological examination. To confirm the changes, a pH measurement can be made and a cytology to determine a vaginal maturation index. When these symptoms are associated with anguish and discomfort, there may be a case of sexual dysfunction, of which there are known risk factors for their presence such as age as such, couple problems, health status, self-esteem, among others. That is why, as to treatment, it is important to make an interdisciplinary approach.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Atrofia vaginal]]></kwd>
<kwd lng="es"><![CDATA[hormonal]]></kwd>
<kwd lng="es"><![CDATA[menopausia]]></kwd>
<kwd lng="es"><![CDATA[epitelio vaginal]]></kwd>
<kwd lng="en"><![CDATA[Vaginal atrophy]]></kwd>
<kwd lng="en"><![CDATA[hormonal]]></kwd>
<kwd lng="en"><![CDATA[menopause]]></kwd>
<kwd lng="en"><![CDATA[vaginal epithelium]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Farage]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Maibach]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lifetime changes in the vulva and vagina]]></article-title>
<source><![CDATA[Arch Gynecol Obst]]></source>
<year>2006</year>
<volume>273</volume>
<page-range>195-202</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sadler]]></surname>
<given-names><![CDATA[TW]]></given-names>
</name>
</person-group>
<source><![CDATA[Langman Embiología Médica]]></source>
<year></year>
<edition>11</edition>
<page-range>246-63</page-range><publisher-name><![CDATA[Wolters Kluwer Health España]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gartner]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
<name>
<surname><![CDATA[Hiatt]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<source><![CDATA[Atlas de Histología]]></source>
<year>2007</year>
<edition>3</edition>
<page-range>484-8</page-range><publisher-name><![CDATA[McGraw- Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castelo-Branco]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cancelo]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Villero]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of postmenopausal vaginal atrophy and atrophic vaginitis]]></article-title>
<source><![CDATA[Maturitas]]></source>
<year>2005</year>
<volume>52</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>S46</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Forsberg]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A morphologist's approach to the vagina--age-related changes and estrogen sensitivity]]></article-title>
<source><![CDATA[Maturitas]]></source>
<year>1995</year>
<volume>22</volume>
<numero>^sS7</numero>
<issue>^sS7</issue>
<supplement>S7</supplement>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Halter]]></surname>
<given-names><![CDATA[B. Jeffrey]]></given-names>
</name>
<name>
<surname><![CDATA[Joseph]]></surname>
<given-names><![CDATA[G. Ouslander]]></given-names>
</name>
<name>
<surname><![CDATA[Mary]]></surname>
<given-names><![CDATA[E. Tinetti]]></given-names>
</name>
<name>
<surname><![CDATA[Studenski]]></surname>
<given-names><![CDATA[Stephanie]]></given-names>
</name>
<name>
<surname><![CDATA[Kevin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[High, Sanjay Asthana. Hazzard´s Geriatric Medicine and Gerontology]]></source>
<year>2009</year>
<edition>6</edition>
<page-range>1010-5</page-range><publisher-name><![CDATA[McGraw-Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Fernando Morales]]></given-names>
</name>
</person-group>
<source><![CDATA[Tratado de Geriatría y Gerontología]]></source>
<year>2017</year>
<edition>2</edition>
<publisher-loc><![CDATA[San José, Costa Rica. ]]></publisher-loc>
<publisher-name><![CDATA[EDNASS-CCSS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Leiblum]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bachmann]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kemmann]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Colburn]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Sartzman]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vaginal Atrophy in the Postmenopausal Woman]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1983</year>
<volume>249</volume>
<numero>16</numero>
<issue>16</issue>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nilsson]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Risberg]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Heimer]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The vaginal epithelium in the postmenopause--cytology, histology and pH as methods of assessment]]></article-title>
<source><![CDATA[Maturitas]]></source>
<year>1995</year>
<volume>21</volume>
<numero>51</numero>
<issue>51</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dennerstein]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Guthrie]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Hayes]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sexual function, dysfunction, and sexual distress in a prospective, population-based simple of mid-aged, Australian-born women]]></article-title>
<source><![CDATA[J Sex Med]]></source>
<year>2008</year>
<volume>5</volume>
<numero>2291</numero>
<issue>2291</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lewis]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Fugl-Meyer]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Bosch]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology/risk factors of sexual dysfunction]]></article-title>
<source><![CDATA[J Sex Med]]></source>
<year>2004</year>
<volume>1</volume>
<numero>35</numero>
<issue>35</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nappi]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Cucinella]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Martella]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Female sexual dysfunction (FSD): Prevalence and impact on quality of life]]></article-title>
<source><![CDATA[Maturitas]]></source>
<year>2016</year>
<volume>94</volume>
<numero>87</numero>
<issue>87</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
