Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy

Sharon J Parish, Rossella E Nappi, Michael L Krychman, Susan Kellogg-Spadt, James A Simon, Jeffrey A Goldstein, Sheryl A Kingsberg, Sharon J Parish, Rossella E Nappi, Michael L Krychman, Susan Kellogg-Spadt, James A Simon, Jeffrey A Goldstein, Sheryl A Kingsberg

Abstract

Several recent, large-scale studies have provided valuable insights into patient perspectives on postmenopausal vulvovaginal health. Symptoms of vulvovaginal atrophy, which include dryness, irritation, itching, dysuria, and dyspareunia, can adversely affect interpersonal relationships, quality of life, and sexual function. While approximately half of postmenopausal women report these symptoms, far fewer seek treatment, often because they are uninformed about hypoestrogenic postmenopausal vulvovaginal changes and the availability of safe, effective, and well-tolerated treatments, particularly local vaginal estrogen therapy. Because women hesitate to seek help for symptoms, a proactive approach to conversations about vulvovaginal discomfort would improve diagnosis and treatment.

Keywords: health care professional; hypoactive sexual desire disorder; local vaginal estrogen therapy; quality of life; urinary tract infection; vulvovaginal atrophy.

References

    1. US Census Bureau Statistical Abstract of the United States: 2012 Table 104. Expectation of Life at Birth, 1970 to 2008, and Projections, 2010 to 2020 Washington, DC: US Census Bureau; 2011Available from: Accessed April 6, 2012
    1. US Census Bureau Statistical Abstract of the United States: 2012 Table 7. Resident Population by Sex and Age: 1980 to 2010 Washington, DC: US Census Bureau; 2011Available from: Accessed April 6, 2012
    1. Nichols HB, Trentham-Dietz A, Hampton JM, et al. From menarche to menopause: trends among US women born from 1912 to 1969. Am J Epidemiol. 2006;164(10):1003–1011.
    1. Obermeyer CM, Reher D, Alcala LC, Price K. The menopause in Spain: results of the DAMES (Decisions At MEnopause) study. Maturitas. 2005;52(3–4):190–198.
    1. Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med. 2009;6(8):2133–2142.
    1. Wyeth REVEAL: Revealing Vaginal Effects at Mid-Life: Surveys of Postmenopausal Women and Health Care Professionals who Treat Postmenopausal Women Madison, NJ: Wyeth; 2009Available from: Accessed April 6, 2012
    1. Nappi RE, Kokot-Kierepa M. Women’s voices in the menopause: results from an international survey on vaginal atrophy. Maturitas. 2010;67(3):233–238.
    1. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views and Attitudes (VIVA) – results from an international survey. Climacteric. 2012;15(1):36–44.
    1. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010;85(1):87–94.
    1. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician. 2000;61(10):3090–3096.
    1. Gass ML, Cochrane BB, Larson JC, et al. Patterns and predictors of sexual activity among women in the Hormone Therapy trials of the Women’s Health Initiative. Menopause. 2011;18(11):1160–1171.
    1. North American Menopause Society The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. Menopause. 2007;14(3 Pt 1):357–369. quiz 370–371.
    1. Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas. 1996;23(3):259–263.
    1. van der Laak JA, de Bie LM, de Leeuw H, de Wilde PC, Hanselaar AG. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol. 2002;55(6):446–451.
    1. Panay N, Maamari R. Treatment of postmenopausal vaginal atrophy with 10-μg estradiol vaginal tablets. Menopause Int. 2012;18(1):15–19.
    1. Cumming GP, Currie HD, Moncur R, Lee AJ. Web-based survey on the effect of menopause on women’s libido in a computer-literate population. Menopause Int. 2009;15(1):8–12.
    1. Cumming GP, Herald J, Moncur R, Currie H, Lee AJ. Women’s attitudes to hormone replacement therapy, alternative therapy and sexual health: a web-based survey. Menopause Int. 2007;13(2):79–83.
    1. Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active post-menopausal women. Menopause. 2008;15(4 Pt 1):661–666.
    1. Simon JA, Komi J. Vulvovaginal atrophy (VVA) negatively impacts sexual function, psychosocial well-being, and partner relationships; Proceedings of the North American Menopause Society (NAMS); October 3–6, 2007; Dallas, TX, USA.
    1. Avis NE, Brockwell S, Randolph JF, Jr, et al. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women’s Health Across the Nation. Menopause. 2009;16(3):442–452.
    1. Kingsberg S, Althof SE. Evaluation and treatment of female sexual disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(Suppl 1):S33–S43.
    1. McGahuey CA, Gelenberg AJ, Laukes CA, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther. 2000;26(1):25–40.
    1. Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther. 2002;28(4):317–330.
    1. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–978.
    1. Lindau ST, Schumm L P, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–774.
    1. Rust J, Derogatis L, Rodenberg C, Koochaki P, Schmitt S, Golombok S. Development and validation of a new screening tool for hypoactive sexual desire disorder: The Brief Profile of Female Sexual Function (B-PFSF) Gynecol Endocrinol. 2007;23(11):638–644.
    1. Nappi RE, Lello S, Melis GB, Albani F, Polatti F, Genazzani AR. LEI (Lack of tEstosterone Impact) survey in a clinical sample with surgical menopause. Climacteric. 2009;12(6):533–540.
    1. Schneidewind-Skibbe A, Hayes RD, Koochaki PE, Meyer J, Dennerstein L. The frequency of sexual intercourse reported by women: a review of community-based studies and factors limiting their conclusions. J Sex Med. 2008;5(2):301–335.
    1. Avis NE, Zhao X, Johannes CB, Ory M, Brockwell S, Greendale GA. Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women’s Health Across the Nation (SWAN) Menopause. 2005;12(4):385–398.
    1. Brown JS, Vittinghoff E, Kanaya AM, Agarwal SK, Hulley S, Foxman B, Heart and Estrogen/Progestin Replacement Study Research Group Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors. Obstet Gynecol. 2001;98(6):1045–1052.
    1. Eriksen B. A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women. Am J Obstet Gynecol. 1999;180(5):1072–1079.
    1. Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev. 2008;2:CD005131.
    1. Cody JD, Richardson K, Moehrer B, Hextall A, Glazener CM. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2009;4:CD001405.
    1. Wennberg AL, Molander U, Fall M, Edlund C, Peeker R, Milsom I. A longitudinal population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in women. Eur Urol. 2009;55(4):783–791.
    1. Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R. Help-seeking behavior of women with self-reported distressing sexual problems. J Womens Health (Larchmt) 2009;18(4):461–468.
    1. Nappi RE, Davis SR. The use of hormone therapy for the maintenance of urogynecological and sexual health post WHI. Climacteric. 2012;15(3):267–274.
    1. Santen RJ, Allred DC, Ardoin SP, et al. Endocrine Society Postmenopausal hormone therapy: an Endocrine Society scientific statement. J Clin Endocrinol Metab. 2010;95(7 Suppl 1):s1–s66.
    1. Sturdee DW, Panay N, International Menopause Society Writing Group Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–522.
    1. North American Menopause Society The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause. 2012;19(3):257–271.
    1. Sobecki JN, Curlin FA, Rasinski KA, Lindau ST. What we don’t talk about when we don’t talk about sex: results of a national survey of US obstetrician/gynecologists. J Sex Med. 2012;9(5):1285–1294.
    1. Bachmann GA, Leiblum SR, Grill J. Brief sexual inquiry in gynecologic practice. Obstet Gynecol. 1989;73(3 Pt 1):425–427.
    1. Sadovsky R, Alam W, Enecilla M, Cosiquien R, Tipu O, Etheridge-Otey J. Sexual problems among a specific population of minority women aged 40–80 years attending a primary care practice. J Sex Med. 2006;3(5):795–803.
    1. Pandit L, Ouslander JG. Postmenopausal vaginal atrophy and atrophic vaginitis. Am J Med Sci. 1997;314(4):228–231.
    1. Beard MK. Atrophic vaginitis. Can it be prevented as well as treated? Postgrad Med. 1992;91(6):257–260.
    1. Osmers R, Völksen M, Schauer A. Vaginosonography for early detection of endometrial carcinoma? Lancet. 1990;335(8705):1569–1571.

Source: PubMed

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