Prevalence and Impact of Vaginal Symptoms Among Postmenopausal Women

Abstract

Introduction Vulvovaginal atrophy (VVA) is reported by one-quarter to one-half of postmenopausal women. Aim We evaluated the prevalence, inconvenience of, and issues surrounding hormone use for VVA symptoms in women who were current, past, and never users of menopausal hormone therapy (MHT), along with the relationship of sexual activity to VVA symptoms. Methods An online survey was sent to 3,471 women ≥45 years old participating in a panel of approximately 43,000 U.S. adults maintained by Knowledge Networks. Respondents were stratified by MHT use (current, past, and never) and sexual activity (sexually active and not sexually active). Final respondent data underwent a poststratification process and Chi-square analysis of hormone use and VVA by sexual activity. Main Outcome Measures Percent, calculated as the ratio of response over total responding for each survey question for all and stratified respondents. Results Forty-five percent (1,038/2,290) of respondents (age range 45–89 years; mean 60.7 years) were postmenopausal and currently or previously experienced VVA. Approximately 60% of past or never users of MHT reported vaginal symptoms; >90% found them bothersome. In comparison, 82% of current users reported VVA symptoms prior to use. 85% of all respondents were aware of safety issues associated with MHT. The prevalence and perceived severity of VVA symptoms were substantial but less frequent in nonsexually active women. Analysis of MHT use by past or current hormone use indicated a trend away from oral dosing and towards patch or vaginal hormones. Conclusions Postmenopausal women have a high rate of VVA symptoms. Those who use MHT do so for multiple reasons—hot flashes, VVA, bone protection, dyspareunia—and most have concerns about long-term safety, despite the fact that the majority of MHT use was for >5 years. Safety concerns and lack of physician recommendation were major reasons for not using or discontinuing MHT.

Perimenopause: From Research to Practice

“…Vaginal symptoms are common in postmenopausal women, and vaginal dryness, in particular, is reported to occur in about one-quarter to one-third [42][43][44] women. The constellation of symptoms of vaginal dryness, irritation, and dysuria has been named genitourinary syndrome of menopause (GSM).…”

Profile of Ospemifene in the Breast

“…4,16 However, specific findings of the Women's Health Initiative study raised concern about the safety of systemic estrogen therapy. 1,4,5,17 These concerns may have limited patient and physician acceptance of estrogen. Even with vaginal estrogen, safety concerns such as breast cancer risk can be a barrier to treatment.…”

Macro-regional variation in attitudes toward and experiences of vulvar and vaginal atrophy among Italian post-menopausal women: a post hoc analysis of REVIVE survey data

“…It is characterized by vaginal dryness and itching, pain during sexual intercourse, urinary urgency and urge incontinence, symptoms which can worsen over time [2,3]. While it is hard to accurately estimate the prevalence of VVA, US and European survey data from the last 10 years gave figures ranging from 38 to 54% [4][5][6]. These and other data confirm that VVA remains a major public health problem.…”