Santiago Palacios1, Rossella E Nappi2, Marla Shapiro3, Nilson Roberto de Melo4, María Celeste Osorio Wender5, César Eduardo Fernandes6, Dolores Pardini7, Rogério Bonassi Machado8, Jaime Kulak9, Cuauhtémoc Celis-González10, Mabel T Martino11, Rita R Pizzi12, Paulina Villaseca13, Eduardo Storch14, Luis Fernando Danckers15, José Alberto Hernández-Bueno16. 1. Palacios Institute of Women's Health, Madrid, Spain. 2. Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. 3. Department of Family and Community Medicine, University of Toronto, Ontario, Canada. 4. Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil. 5. Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Brazil. 6. Department of Obstetric and Gynecology, ABC Medical School, Santo André, São Paulo, Brazil. 7. Department of Endocrinology, Federal University of São Paulo, São Paulo, Brazil. 8. Department of Gynecology, Jundiaí Medical School, São Paulo, Brazil. 9. Department of Obstetrics & Gynecology, Federal University of Parana, Curitiba, Brazil. 10. Hospital de Ginecología y Obstetricia No.4 "Luis Castelazo Ayala," Mexican Institute of Social Security, Mexico City, Mexico. 11. Asociacion de Obstetricia y Ginecologia de Rosario (ASOGIR), Rosario, Argentina (member of the Collaborative Group for Research of the Climacteric in Latin America [REDLINC]). 12. Department of Endocrinology, Universidad Central de Venezuela, Caracas, Venezuela. 13. Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile. 14. Sociedad Uruguaya de Ginecotocología, Sociedad Uruguaya de Endocrinología Ginecológica y Menopausia, Montevideo, Uruguay. 15. REDLINC, Peru. 16. Atención Medica Integral para la Mujer, S.C., Naucalpan, Mexico.
Abstract
OBJECTIVE: In the absence of guidelines specific for Latin America, a region where the impact of menopause is becoming increasingly important, an evidence-based specialist opinion on management of vaginal atrophy will help improve outcomes. METHODS: An advisory board meeting was convened in São Paulo, Brazil, to discuss practical recommendations for managing vaginal atrophy in women in Latin America. Before the meeting, physicians considered various aspects of the condition, summarizing information accordingly. This information was discussed during the meeting. The expert consensus is now summarized. RESULTS: In Latin America, given the relatively early age of menopause, it will be beneficial to raise awareness of vaginal atrophy among women before they enter menopause, considering cultural attitudes and involving partners as appropriate. Women should be advised about lifestyle modifications, including attention to genital hygiene, clothing, and sexual activity, and encouraged to seek help as soon as they experience vaginal discomfort. Although treatment can be started at any time, prompt treatment is preferable. A range of treatments is available. By addressing the underlying pathology, local estrogen therapy can provide effective symptom relief, with choice of preparation guided by patient preference. An individualized treatment approach should be considered, giving attention to patients' specific situations. CONCLUSIONS: It is critical that women are empowered to understand vaginal atrophy. Educating women and healthcare providers to engage in open dialogue will facilitate appreciation of the benefits and means of maintaining urogenital health, helping to improve outcomes in middle age and beyond. Women should receive this education before menopause.
OBJECTIVE: In the absence of guidelines specific for Latin America, a region where the impact of menopause is becoming increasingly important, an evidence-based specialist opinion on management of vaginal atrophy will help improve outcomes. METHODS: An advisory board meeting was convened in São Paulo, Brazil, to discuss practical recommendations for managing vaginal atrophy in women in Latin America. Before the meeting, physicians considered various aspects of the condition, summarizing information accordingly. This information was discussed during the meeting. The expert consensus is now summarized. RESULTS: In Latin America, given the relatively early age of menopause, it will be beneficial to raise awareness of vaginal atrophy among women before they enter menopause, considering cultural attitudes and involving partners as appropriate. Women should be advised about lifestyle modifications, including attention to genital hygiene, clothing, and sexual activity, and encouraged to seek help as soon as they experience vaginal discomfort. Although treatment can be started at any time, prompt treatment is preferable. A range of treatments is available. By addressing the underlying pathology, local estrogen therapy can provide effective symptom relief, with choice of preparation guided by patient preference. An individualized treatment approach should be considered, giving attention to patients' specific situations. CONCLUSIONS: It is critical that women are empowered to understand vaginal atrophy. Educating women and healthcare providers to engage in open dialogue will facilitate appreciation of the benefits and means of maintaining urogenital health, helping to improve outcomes in middle age and beyond. Women should receive this education before menopause.