Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey

Abstract

Objectives The aim of the European REVIVE survey was to achieve a better understanding of vulvovaginal atrophy (VVA), a chronic and progressive condition after menopause. We investigated perceptions, experiences and needs in terms of sexual and vaginal health in a sample of European postmenopausal women. Methods An online internet based survey was conducted in Italy, Germany, Spain and the UK with a total surveyed sample of 3768 postmenopausal women (age: 45–75 years). Results The most common VVA symptom was vaginal dryness (70%). VVA has a significant impact on the ability to be intimate (62%), to enjoy sexual intercourse (72%) and to feel sexual spontaneity (66%). Postmenopausal women with VVA are sexually active (51%), but their sexual drive is reduced. Health-care professionals (HCPs) have discussed VVA with postmenopausal women (62%), but they initiated the conversation only in 10% of the cases. The most common treatments for VVA are over-the-counter, non-hormonal, local vaginal products. Thirty-two per cent of postmenopausal women were naïve to any kind of treatment, whereas discussion with the HCP was relevant to be on current treatment (60% of postmenopausal women that discussed VVA with a HCP vs. 23% who did not). The top reasons for poor compliance with vaginal treatments were: not bothersome enough symptoms (18%); vaginal changes not therapeutically reversed (18%); relief from VVA symptoms (17%). Approximately 45% were satisfied with treatment. The most frequent disliked aspects of treatment were the route of administration or the messiness. The fear of hormones was common in postmenopausal women using vaginal prescription products. Conclusions The European REVIVE survey confirmed that VVA symptoms are frequent in postmenopausal women and demonstrates a significant impact on quality of life and sexual life. However, the condition is still under-diagnosed and under-treated, with a high rate of dissatisfaction for actual available treatments in the four European countries surveyed. The discussion of symptoms with HCPs seems the most critical factor for diagnosis and treatment of VVA.

Female sexual dysfunction amongst rural postmenopausal woman

“…[11][12][13][14] In our study, 51.9 % of women were sexually active which were comparable to the study of 58.6%, 51%, 52% and 40% sexually active in shah et al 15 , Nappi RE et al 16 , Jennifer S et al 17 and Versi E et al 18 studies respectively.…”

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

“…Conducted in 2014, the European REVIVE survey [2] used the same methodology as the original US REVIVE survey [5]. Briefly, women aged 45-75 years and living in Italy, Germany, Spain, or the UK were screened for eligibility based on cessation of menstruation, menopause, and lifetime history of VVA symptoms.…”

“…The European REVIVE study [2] and other international studies [8,9,13,14] reveal cultural differences in the impact of VVA on female sexuality and relationships. A recent European interview-and survey-based study further identified personality traits as an important factor influencing women's attitudes and behavior regarding VVA [15].…”

“…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].…”

“…When the US REVIVE survey was replicated in Europe (Italy, Germany, Spain, and the UK), over two-thirds of the women who had ever had VVA reported a negative effect on their sex life [2]. In spite of this, only 45% of respondents were receiving treatment at the time of the survey, and many expressed dissatisfaction with VVA treatments.…”