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Women still uninformed about menopausal vulvar symptoms, treatments
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Results of the Women’s EMPOWER survey reveal that postmenopausal women are still relatively unaware of some symptoms of menopause and their available treatments, according to findings presented at the Annual Meeting of the North American Menopause Society.
“The results of the Women’s EMPOWER survey demonstrate and reinforce that, even with multimedia marketing and educational strategies in the years after other major [vulvar and vaginal atrophy] surveys, minimal progress has been made toward increasing women’s awareness and understanding of [vulvar and vaginal atrophy],” Michael Krychman, MD, FACOG, MPH, of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, said in a press release. “Women remain naive to the safe and effective treatment options that are currently available and are still, for the most part, under-informed and undertreated.”
Krychman and colleagues conducted an internet-based survey, EMPOWER, that included 1,858 postmenopausal women with symptoms of vulvar and vaginal atrophy to evaluate women’s awareness of the condition and their behaviors and attitudes associated with treatment of symptoms.
The survey results were compared with results from six previously conducted surveys — REVEAL, VIVA US, Healthy Women #1, REVIVE, CLOSER North America and Healthy Women #2 — evaluating knowledge, behaviors and attitudes related to vulvar and vaginal atrophy.
Consistent with the previous six surveys, the EMPOWER survey revealed that postmenopausal participants generally failed to recognize vulvar and vaginal atrophy and its course and were reluctant to discuss symptoms with their health care providers. Participants also reported that they lacked knowledge about therapeutic options to alleviate symptoms.
There was no awareness of the medical status of vulvar and vaginal atrophy in 81% of EMPOWER survey respondents and 70% of Healthy Women #2 respondents. Most participants of the VIVA survey did not attribute symptoms to vulvar and vaginal atrophy (90%), and 43% did not recognize it as a chronic condition. More than 66% of EMPOWER respondents and 46% of Healthy Women #1 respondents were not familiar with most of the prescription vulvar and vaginal atrophy products. Compared with 7% of EMPOWER respondents, 31% of CLOSER respondents used prescription therapy.
Lack of efficacy (69%) and cost (32%) were reported as concerns and dislikes of currently available treatments in the REVIVE survey compared with 26% and 12%, respectively, in the EMPOWER survey.
“Vulvar and vaginal atrophy/genitourinary syndrome of menopause is a common and treatable condition that is inadequately addressed by clinicians and patients,” Krychman told Endocrine Today. “Many women are suffering in silence and warrant treatment. By promoting the discussion among patients and clinicians, this is a treatable condition for which women can achieve relief of the morbidities and adverse impact on a woman’s quality of life. Ongoing research is underway to find treatment options to address the needs of both patients and clinicians. One such product is the investigational new vaginal softgel capsule (TherapeuticsMD) that is pending FDA approval.” – by Amber Cox
Reference:
Krychman M, et al. P-71. Presented at: Annual Meeting of the North American Menopause Society; Oct. 5-8, 2016; Orlando, Fla.
Disclosure: Krychman reports financial ties with Shionogi and TherapeuticsMD.
Perspective
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James H. Pickar, MD
An oral presentation by Sheryl Kingsberg, PhD, and this poster on the EMPOWER survey addressed women's perceptions and knowledge on postmenopausal vulvar and vaginal atrophy and its treatments. This condition is common and affects up to two-thirds of postmenopausal women. The EMPOWER survey, conducted in 2016, was an internet-based survey of 1,858 postmenopausal women in the United States reporting symptoms of vulvar and vaginal atrophy. It demonstrated that although symptoms, such as dyspareunia, vaginal dryness and vaginal itching or irritation, were very common, relatively few women were using or had used prescription hormone treatments, and half had never used any treatment whether prescription or over-the-counter. Women were concerned with the safety of hormones, the perceived risks associated with systemic absorption of hormones and issues with the vaginal application of current products (eg, messiness and applicators).
The poster compared results from the EMPOWER survey with a number of prior vulvar and vaginal atrophy surveys. Consistently these surveys demonstrate that postmenopausal women frequently do not recognize symptoms of vulvar and vaginal atrophy, the association with menopause and the chronic progressive nature of this medical condition. Although these studies indicate that women want accurate medical information from their health care providers, communication related to vulvar and vaginal atrophy between providers and their postmenopausal patients is unfortunately limited, and these surveys demonstrate that we have made little progress in increasing women's awareness and understanding of the condition and its treatment options. These studies suggest that providers need to make a greater effort to educate and initiate discussions with their postmenopausal patients regarding vulvar and vaginal atrophy.
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