This article is more than 5 years old. Information may no longer be current.
Patient education necessary to improve management of VVA
Click Here to Manage Email Alerts
Despite the high prevalence and progressively negative symptoms of vulvar and vaginal atrophy among postmenopausal women, several barriers that prevent sufficient diagnosis and effective treatment remain, according to researchers.
“In this survey, many women reported that vulvar and vaginal atrophy (VVA) has an impact on their lives — particularly their intimate relationships. Despite this, almost half of the women admitted to not discussing symptoms with their health care professionals because they were embarrassed or felt the topic was too difficult to discuss. This signals a need for increased awareness and communication,” Sheryl A. Kingsberg, PhD, clinical psychologist at Case Western Reserve University School of Medicine, said in a press release.
Kingsberg and colleagues used an online survey to calculate women’s symptoms, perceptions and communication with a health care provider regarding VVA. The cohort included 3,046 postmenopausal patients aged 45 to 75 years.
According to survey results, dryness (55%), dyspareunia (44%) and irritation (37%) were the most common VVA symptoms reported by patients. Data indicate these symptoms negatively affected sexual intercourse for more than half of patients included (59%). There also were reports of interference with sleep (24%), quality of life (23%) and temperament (23%), researchers wrote.
However, only 24% of women credited these symptoms to menopause and only 12% attributed them to hormonal changes. In addition, only 56% of patients spoke to a health care provider about their symptoms and 29% used topical over-the-counter products. Only 11% used vaginal prescription therapies, researchers wrote. Moreover, 62% of those surveyed who discussed their symptoms with a health care provider used OTC products.
These findings indicate that education is warranted to encourage this patient population to improve symptoms and treatment adherence.
Disclosure: Kingsberg receives financial support from Shionogi, Inc., Novo Nordisk and Pfizer. See the study for a full list of disclosures.
Perspective
Back to Top
JoAnn V. Pinkerton, MD
Vulvovaginal atrophy (VVA) is a chronic, progressive condition characterized by thinning of the superficial epithelial lining of the vagina and loss of elasticity and connective tissue in vulva and vagina with an increase in vaginal pH over 5, with symptoms reported in up to 50% of postmenopausal women. In the REVIVE sample of 3,046 postmenopausal women, the most common symptoms were vaginal dryness (55%), dyspareunia (44%, painful sex), and irritation (37%) affecting sex in more than half (59%) of patients. Only one quarter recognized menopause with decline in estrogen as the cause, half (56%) discussed these symptoms with a health care provider and only 40% used a treatment of either vaginal over-the-counter products (29%) or vaginal prescription therapy (11%).
Barriers to treatment for VVA include reluctance on both the patient’s and the health care provider’s part to discuss vaginal symptoms and lack of awareness of the role of menopause and decreasing estrogen as direct etiology. Dissatisfaction with topical or vaginal OTC or prescription therapies may lead to inadequate treatment or resolution of symptoms.
Current treatment options include vaginal lubricants and moisturizers, prescription systemic hormone therapies, a new prescription targeted SERM (selective estrogen receptor modulator) ospemifene and vaginal prescription therapies (vaginal creams, vaginal tablets, vaginal ring).
The REVIVE survey reminds us that women with symptomatic VVA are concerned with interference with sex and loss of intimacy with partners. Education about the progressive, chronic nature of VVA and variety of treatment options are needed to improve therapeutic results and patient satisfaction.
Click Here to Manage Email Alerts