Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy (original) (raw)
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JAMA internal medicine, 2018
Nearly half of postmenopausal women report bothersome vulvovaginal symptoms, but few data support the efficacy of 2 commonly recommended treatments. To compare the efficacy of a low-dose vaginal estradiol tablet and a vaginal moisturizer, each vs placebo, for treatment of moderate-to-severe postmenopausal vulvovaginal symptoms. This 12-week multicenter randomized clinical trial enrolled postmenopausal women with moderate to severe symptoms of vulvovaginal itching, pain, dryness, irritation, or pain with penetration. Vaginal 10-μcg estradiol tablet (daily for 2 weeks, then twice weekly) plus placebo gel (3 times a week) (n = 102) vs placebo tablet plus vaginal moisturizer (n = 100) vs dual placebo (n = 100). The main outcome was decrease in severity (0-3) of most bothersome symptom (MBS) between enrollment and 12 weeks. Additional measures included a composite vaginal symptom score, Female Sexual Function Index (FSFI) score (2-36), modified Female Sexual Distress Score-Revised item 1...
An overview of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women
Journal of Basic and Clinical Reproductive Sciences, 2012
Menopause and the climacteric period are associated with adverse risk factors for the development of vulvovaginal atrophyrelated sexual dysfunction. Sexual dysfunction is a common problem in postmenopausal women, often underdiagnosed, inadequately treated, frequently overlooked, and most often impairing the quality of life of these women. To provide clinicians with current information on vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. This study is a literature review on vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. Relevant publications were identified through a search of PubMed and Medline, selected references, journals, and textbooks on this topic, and were included in the review. The prevalence of female sexual dysfunction increases with age. It is a common multidimensional problem for postmenopausal women that alter the physiological, biochemical, psychological, and sociocultural environment of a woman. Menopause-related sexual dysfunction may not be reversible without therapy. Estrogen therapy is the most effective option and is the current standard of care for vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. Sexual dysfunction is a common multidimensional problem for postmenopausal women and often impairs the quality of life of these women. Estrogen preparations are the most effective treatment. Selective estrogen receptor modulators, vaginal dehydroepiandrostenedione, vaginal testosterone, and tissue-selective estrogen complexes are promising therapies, but further studies are required to confirm their role, efficacy, and safety.
An Overview of Vulvovaginal AtrophyâRelated Sexual Dysfunction in Postmenopausal Women
Journal of Basic and Clinical Reproductive Sciences, 2012
Menopause and the climacteric period are associated with adverse risk factors for the development of vulvovaginal atrophyrelated sexual dysfunction. Sexual dysfunction is a common problem in postmenopausal women, often underdiagnosed, inadequately treated, frequently overlooked, and most often impairing the quality of life of these women. To provide clinicians with current information on vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. This study is a literature review on vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. Relevant publications were identified through a search of PubMed and Medline, selected references, journals, and textbooks on this topic, and were included in the review. The prevalence of female sexual dysfunction increases with age. It is a common multidimensional problem for postmenopausal women that alter the physiological, biochemical, psychological, and sociocultural environment of a woman. Menopause-related sexual dysfunction may not be reversible without therapy. Estrogen therapy is the most effective option and is the current standard of care for vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. Sexual dysfunction is a common multidimensional problem for postmenopausal women and often impairs the quality of life of these women. Estrogen preparations are the most effective treatment. Selective estrogen receptor modulators, vaginal dehydroepiandrostenedione, vaginal testosterone, and tissue-selective estrogen complexes are promising therapies, but further studies are required to confirm their role, efficacy, and safety.
Iranian postmenopausal women’s experiences of treatment of symptomatic vulvovaginal atrophy
Climacteric, 2017
Objectives: Our aim was to explore the experiences of Iranian postmenopausal women who sought medical help for their symptomatic vulvovaginal atrophy (VVA). Methods: Five focus group discussions (FGDs) were conducted. Participants had to be postmenopausal; had bothersome symptoms of VVA for which they came to the clinic; had previously sought medical help for their VVA; and had confirmed physical signs of VVA upon examination by a gynecologist. Results: Twenty-five women, aged 49-60 years participated in the five FGDs. Twenty women said they currently had >1 VVA symptom at presentation to the clinic. Four major themes emerged from the women's narrative stories: (1) negative impact of VVA on women's life, (2) psychological distress associated with VVA, (3) negative impact of VVA on marriage and relationship, (4) inadequate symptom relief from available treatments due to lack of awareness of VVA treatment options. None of the participants reported ongoing treatment of their VVA with local low-dose estrogen. Women further commented that, although local estrogen products were costly, they would like to use them if they were prescribed. Conclusions: Considering the negative impact of VVA symptoms on women's lives, health professionals in Iran should be prescribing approved and effective therapies for symptomatic women.
2005
As a result of an estrogen deficiency caused by the onset of menopause, substantial modifications of the hormone-dependent tissues and the urogenital tract occur, including a rise in vaginal pH, decreased or discontinued production of glycogen, a reduction in the elasticity and thickness of the vaginal wall, and reduced blood flow and secretions in the vagina. Vaginal atrophy, which occurs in 40% of postmenopausal women, may occur with characteristic symptoms such as itching, dryness, dyspareunia, and dysuria, and with repercussions on the woman’s quality of life. Vaginal atrophy can be treated with hormonal therapy either topically or systemically. When these treatments are poorly tolerated or contraindicated (history of cancer, thromboembolism, etc.), local, non-hormonal therapies with a moisturizing and/or lubricating action, such as cremes or gels, may be a valid alternative. The VALYD (Vaginal Dryness and Quality of Life in Menopausal Women) study conducted under the auspices o...
Current treatment options for postmenopausal vaginal atrophy
International journal of women's health, 2018
Vulvovaginal atrophy (VVA) is a silent epidemic that affects up to 50%-60% of postmenopausal women who are suffering in silence from this condition. Hormonal changes, especially hypoestrogenism inherent in menopause, are characterized by a variety of symptoms. More than half of menopausal women are concerned about the symptoms of VVA, such as dryness, burning, itching, vaginal discomfort, pain and burning when urinating, dyspareunia, and spotting during intercourse. All these manifestations significantly reduce the quality of life and cause discomfort in the sexual sphere. However, according to research, only 25% of patients with the symptoms of VVA receive adequate therapy. This is probably due to the lack of coverage of this problem in the society and the insufficiently active position of specialists in the field of women's health regarding the detection of symptoms of VVA. Many patients are embarrassed to discuss intimate complaints with a specialist, which makes it difficult...
Predictors of impact of vaginal symptoms in postmenopausal women
Menopause, 2016
Objective: This study aims to identify factors associated with greater impact of vaginal symptoms on the functioning and well-being of postmenopausal women. Methods: Postmenopausal women who reported vaginal dryness, itching, irritation, or pain with sexual activity completed the multidimensional Day-today Impact of Vaginal Aging (DIVA) questionnaire and underwent assessment of multiple sociodemographic and clinical factors that have the potential to influence the impact of vaginal symptoms. Multivariable linear regression analyses examined relationships between selected participant characteristics and DIVA scale scores assessing symptom impact on activities of daily living, emotional well-being, self-concept and body image, and sexual functioning. Results: Among 745 symptomatic participants, the mean (SD) age was 56 (9) years, and 66% were racial/ethnic minorities. Women with comorbid depression reported greater impact of vaginal symptoms on all dimensions of functioning and well-being measured by the DIVA questionnaire (11%-22% estimated increase in impact scores associated with every three-point increase in Hospital and Anxiety Depression Scale scores). Women with urinary incontinence also reported greater impact of vaginal symptoms on activities of daily living, emotional well-being, and self-concept and body image (27%-37% estimated increase in impact scores). Age, partner status, frequency of sexual activity, general health, and body mass index also predicted greater impact on at least one domain. Conclusions: Findings suggest that special efforts should be made to identify and treat vaginal symptoms in postmenopausal women known to have depression or urinary incontinence, as these women may experience greater impact of vaginal symptoms on multiple domains of functioning and quality of life.
Management of Vaginal Atrophy: Implications from the REVIVE Survey
Clinical Medicine Insights: Reproductive Health, 2014
Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women's Views of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA.
Sexual Medicine, 2013
Vaginal atrophy, which may affect up to 45% of postmenopausal women, is often associated with one or more urinary symptoms, including urgency, increased frequency, nocturia, dysuria, incontinence, and recurrent urinary tract infection. Aims. To provide an overview of the current literature regarding cellular and clinical aspects of vaginal atrophy and response to treatment with local vaginal estrogen therapy. Methods. PubMed searches through February 2012 were conducted using the terms "vaginal atrophy," "atrophic vaginitis," and "vulvovaginal atrophy." Expert opinion was based on review of the relevant scientific and medical literature. Main Outcome Measure. Genitourinary symptoms and treatment of vaginal atrophy from peer-reviewed published literature.
Vaginal Health in Menopausal Women
Medicina
The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of genitourinary syndrome (GSM). This condition has a high prevalence among post-menopausal women and negatively affects a woman’s quality of life. Epidemiology, signs, symptoms, diagnostic criteria of VVA and target treatments for restoring vaginal health are discussed in light of the most recent literature. Issues related to this condition in menopausal women are under-diagnosed, lack objective diagnostic criteria, and consequently under-treated. Over the years, many treatments have been developed but their long-term effectiveness and safety have yet to be clearly defined. Patients are often dissatisfied and stop treatment, suggesting the need for a more personalized and tailored approach to achieve better compliance and thereby effectiveness. The aim of this paper is to provide an overview of the most recent literature on V...