Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women

Panay, Nick; Palacios, Santiago; Bruyniks, Nico; Particco, Martire; Nappi, Rossella E.

doi:10.1016/j.maturitas.2019.03.013

Cited by 47 publications

(45 citation statements)

References 28 publications

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“…68-70 Early initiation is recommended, and benefits of long-term use include sustained relief of GSM symptoms as well as physiological improvements. 71 Multiple vaginal estrogen products (creams, pessaries, or tablets) are available and the choice is determined predominantly by patient preference.…”

Section: Discussionmentioning

confidence: 99%

Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis

et al. 2019

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This report uses data from 2015 and 2016 to examine the use of prescribed medicines by adults living in their own homes in England. It provides information on the number of prescribed medicines taken in the last week, and the proportion of the population taking specific classes of medicines, by sociodemographic and health factors. Key findings  In 2015/16 48% of adults had taken at least one prescribed medicine (not including contraception or nicotine replacement therapy) in the last week. This increased with age from 19% of young adults aged 16 to 24 to more than 90% of those aged 75 and over. The proportion of adults taking one or more prescribed medicines was similar to 2012/13.  In 2015/16, 24% of adults were taking three or more medicines.  The prevalence of prescribed medicine use was higher in more deprived areas: 54% of adults in the most deprived fifth of areas took at least one medicine, compared with 45% in the least deprived areas.  Prescribed medicine use was much higher than average among those with self-reported bad or very bad general health (85%), a limiting or non-limiting longstanding condition (76% and 71% respectively), or probable mental ill health (63%).  The most commonly used prescribed medicines were antihypertensives (by 15% of adults) and lipid-lowering medicines (14%); followed by proton-pump inhibitors for reducing acid in the stomach (11%); analgesics and non-steroidal anti-inflammatory drugs (11%); and antidepressants (10%).

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Section: Discussionmentioning

confidence: 99%

Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis

et al. 2019

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“…Vasomotor symptoms may last for many years after natural or surgical menopause 5–7. Other symptoms, such as those related to vulvovaginal atrophy, are lifelong 8 9…”

Section: Introductionmentioning

confidence: 99%

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

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Coleman

et al. 2020

Int J Gynecol Cancer

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Worldwide, it is estimated that about 1.3 million new gynecological cancer cases are diagnosed each year. For 2018, the predicted annual totals were cervix uteri 569 847, corpus uteri 382 069, ovary 295 414, vulva 44 235, and vagina 17 600. Treatments include hysterectomy with or without bilateral salpingo-oophorectomy, radiotherapy, and chemotherapy. These can result in loss of ovarian function and, in women under the age of 45 years, early menopause. The aim of this position statement is to set out an individualized approach to the management, with or without menopausal hormone therapy, of menopausal symptoms and the prevention and treatment of osteoporosis in women with gynecological cancer. Our methods comprised a literature review and consensus of expert opinion. The limited data suggest that women with low-grade, early-stage endometrial cancer may consider systemic or topical estrogens. However, menopausal hormone therapy may stimulate tumor growth in patients with more advanced disease, and non-hormonal approaches are recommended. Uterine sarcomas may be hormone dependent, and therefore estrogen and progesterone receptor testing should be undertaken to guide decisions as to whether menopausal hormone therapy or non-hormonal strategies should be used. The limited evidence available suggests that menopausal hormone therapy, either systemic or topical, does not appear to be associated with harm and does not decrease overall or disease-free survival in women with non-serous epithelial ovarian cancer and germ cell tumors. Caution is required with both systemic and topical menopausal hormone therapy in women with serous and granulosa cell tumors because of their hormone dependence, and non-hormonal options are recommended as initial therapy. There is no evidence to contraindicate the use of systemic or topical menopausal hormone therapy by women with cervical, vaginal, or vulvar cancer, as these tumors are not considered to be hormone dependent.

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“…Moreover, time since menopause was significantly higher in women treated for VVA. Collectively, EVES data indicate that VVA treatments should ideally be initiated at a younger age when symptoms commence and cause distress, before the condition becomes very severe and difficult to be reverted (108).…”

Section: The Burden Of Vva/gsm On Women's Sexual Function and Qualitymentioning

confidence: 99%

Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women

et al. 2019

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Vaginal health is an essential component of active and healthy aging in women at midlife and beyond. As a consequence of hormonal deprivation and senescence, the anatomy and function of urogenital tissues are significantly affected and vulvovaginal atrophy (VVA) may occur. In a high proportion of postmenopausal women, progressive and chronic VVA symptoms have a strong impact on sexual function and quality of life. The new definition of genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections). Many variables (age, sexual activity and partnership status) influence the clinical impact VVA/GSM symptoms and attitudes of elderly women to consult for receiving effective treatments. Psychosocial factors play a critical role in sexual functioning, but the integrity of the urogenital system is as well important affecting many domains of postmenopausal women's health, including sexual function. Several international surveys have extensively documented the need to improve VVA/GSM management because of the strong impact on women's daily life and on couple's intimacy. Health care providers (HCPs) need to be proactive in the early recognition of VVA/GSM in order to preserve urogenital and sexual longevity, by using hormonal and non-hormonal strategies. The clinical diagnosis is based on genital examination to identify objective signs and on the use of subjective scales to rate most bothersome symptoms (MBS), especially vaginal dryness. Recent studies point to the importance of addressing VVA/GSM as a potential early marker of poor general health in analogy with vasomotor symptoms. Therefore, a standard of VVA/GSM care in elderly women is desirable to enhance physical, emotional and mental well-being.

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Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women

Cited by 47 publications

References 28 publications

Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis

Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women

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