Federica Palma1, Anjeza Xholli1, Angelo Cagnacci2. 1. a Department of Obstetrics and Gynecology and Pediatrics , University of Modena and Reggio Emilia , Modena , Italy and. 2. b Department of Obstetrics and Gynecology and Pediatrics , University of Udine , Udine , Italy.
Abstract
OBJECTIVES: To investigate the management of vaginal atrophy (VA) in a population-based study. STUDY DESIGN: A sub-study of a cross-sectional multicenter study on 913 postmenopausal women. MAIN OUTCOME MEASURES: Management of VA was investigated on the 274 women referring having received a previous diagnosis of VA. RESULTS: Women had received, no therapy (9.8%), systemic hormones (9.2%), intra-vaginal estrogens (44.5%) or local non-hormonal (36.5%) therapy. There was heterogeneity of treatments. Local therapies were given in cycles, and used for a length of time ranging from 1 to 12 months. At the time of the investigation 59.5% of these women were not on treatment, either because following the physician's indication (31.1%) or because spontaneously withdrawing from treatment (68.9%). Reasons for withdrawing from therapy were insufficient symptom relief (46.6%), messiness (24.3%), difficulty in application (7.8%) and vaginal discharge (1.9%). At the time of investigation only 2.9% of treated women did not suffer from VA. CONCLUSIONS: This study underlines the presence of a great confusion about the therapy used for VA, along with patients' dissatisfaction with actual treatments. The emerging evidence is that in real world VA remains untreated.
OBJECTIVES: To investigate the management of vaginal atrophy (VA) in a population-based study. STUDY DESIGN: A sub-study of a cross-sectional multicenter study on 913 postmenopausal women. MAIN OUTCOME MEASURES: Management of VA was investigated on the 274 women referring having received a previous diagnosis of VA. RESULTS:Women had received, no therapy (9.8%), systemic hormones (9.2%), intra-vaginal estrogens (44.5%) or local non-hormonal (36.5%) therapy. There was heterogeneity of treatments. Local therapies were given in cycles, and used for a length of time ranging from 1 to 12 months. At the time of the investigation 59.5% of these women were not on treatment, either because following the physician's indication (31.1%) or because spontaneously withdrawing from treatment (68.9%). Reasons for withdrawing from therapy were insufficient symptom relief (46.6%), messiness (24.3%), difficulty in application (7.8%) and vaginal discharge (1.9%). At the time of investigation only 2.9% of treated women did not suffer from VA. CONCLUSIONS: This study underlines the presence of a great confusion about the therapy used for VA, along with patients' dissatisfaction with actual treatments. The emerging evidence is that in real world VA remains untreated.
Entities:
Keywords:
Genitourinary syndrome of menopause; management; menopause; vaginal atrophy; vaginal health
Authors: Caroline M Mitchell; Susan D Reed; Susan Diem; Joseph C Larson; Katherine M Newton; Kristine E Ensrud; Andrea Z LaCroix; Bette Caan; Katherine A Guthrie Journal: JAMA Intern Med Date: 2018-05-01 Impact factor: 21.873