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Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study.
Maturitas. 2016 Jan; 83:40-4.M

Abstract

OBJECTIVES

Prevalence of vulvar-vaginal atrophy (VVA) has been always investigated by phone or web interview without any objective evaluation. Objective signs associated with symptoms of VVA are now termed genitourinary syndrome of menopause (GSM). This multi-centric study was performed in order to provide nation-wide data on the prevalence and management of GSM.

METHODS

Nine hundred thirteen females, 59.3 ± 7.4 years old asking for a routine gynecological examination were recruited. Diagnosis of GSM was based on patient sensation of vaginal dryness, any objective sign of VVA and a pH > 5.

RESULTS

A 722/913 (79.1%) women were diagnosed with GSM with a prevalence ranging from 64.7% to 84.2%, starting from 1 to 6 years after menopause. Sedentary women were at higher risk of GSM (OR 1.8, 95% CI: 1.3-2.5; p = 0.0005). Recent vaginal infection was more likely in women with GSM (OR 2.48, 95% CI: 1.33-4.62; p = 0.0041). Symptoms reported by women with GSM were vaginal dryness (100%), dyspareunia (77.6%), burning (56.9%), itching (56.6%) and dysuria (36.1%). Signs detected by gynecologists were mucosal dryness (99%), thinning of vaginal rugae (92.1%), pallor of the mucosa (90.7%), mucosal fragility (71.9%) and petechiae (46.7%). Only 274 (30%) of women had had a previous diagnosis of VVA/GSM. These were treated either with no therapy (9.8%), systemic hormone (9.2%), local hormone (44.5%) or local non-hormonal (36.5%) therapy. At the time of our investigation 266 of them (97.1%) still had the disorder.

CONCLUSIONS

GSM is a common, under-diagnosed and under-treated disorder. Measures to improve its early detection and its appropriate management are needed.

Authors+Show Affiliations

Obstetrics and Gynecology, University of Modena and Reggio Emilia, Italy.Obstetrics and Gynecology, University of Modena and Reggio Emilia, Italy.Obstetrics and Gynecology, Policlinico Gemelli of Rome, Italy.Obstetrics and Gynecology, University of Modena and Reggio Emilia, Italy. Electronic address: cagnacci@unimore.it.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26421474

Citation

Palma, F, et al. "Vaginal Atrophy of Women in Postmenopause. Results From a Multicentric Observational Study: the AGATA Study." Maturitas, vol. 83, 2016, pp. 40-4.
Palma F, Volpe A, Villa P, et al. Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study. Maturitas. 2016;83:40-4.
Palma, F., Volpe, A., Villa, P., & Cagnacci, A. (2016). Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study. Maturitas, 83, 40-4. https://doi.org/10.1016/j.maturitas.2015.09.001
Palma F, et al. Vaginal Atrophy of Women in Postmenopause. Results From a Multicentric Observational Study: the AGATA Study. Maturitas. 2016;83:40-4. PubMed PMID: 26421474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study. AU - Palma,F, AU - Volpe,A, AU - Villa,P, AU - Cagnacci,A, AU - ,, Y1 - 2015/09/14/ PY - 2015/05/05/received PY - 2015/08/19/revised PY - 2015/09/11/accepted PY - 2015/10/1/entrez PY - 2015/10/1/pubmed PY - 2016/7/12/medline KW - Genitourinary syndrome of menopause (GSM) KW - Hormone therapy KW - Postmenopausal women KW - Vaginal atrophy KW - Vaginal therapy SP - 40 EP - 4 JF - Maturitas JO - Maturitas VL - 83 N2 - OBJECTIVES: Prevalence of vulvar-vaginal atrophy (VVA) has been always investigated by phone or web interview without any objective evaluation. Objective signs associated with symptoms of VVA are now termed genitourinary syndrome of menopause (GSM). This multi-centric study was performed in order to provide nation-wide data on the prevalence and management of GSM. METHODS: Nine hundred thirteen females, 59.3 ± 7.4 years old asking for a routine gynecological examination were recruited. Diagnosis of GSM was based on patient sensation of vaginal dryness, any objective sign of VVA and a pH > 5. RESULTS: A 722/913 (79.1%) women were diagnosed with GSM with a prevalence ranging from 64.7% to 84.2%, starting from 1 to 6 years after menopause. Sedentary women were at higher risk of GSM (OR 1.8, 95% CI: 1.3-2.5; p = 0.0005). Recent vaginal infection was more likely in women with GSM (OR 2.48, 95% CI: 1.33-4.62; p = 0.0041). Symptoms reported by women with GSM were vaginal dryness (100%), dyspareunia (77.6%), burning (56.9%), itching (56.6%) and dysuria (36.1%). Signs detected by gynecologists were mucosal dryness (99%), thinning of vaginal rugae (92.1%), pallor of the mucosa (90.7%), mucosal fragility (71.9%) and petechiae (46.7%). Only 274 (30%) of women had had a previous diagnosis of VVA/GSM. These were treated either with no therapy (9.8%), systemic hormone (9.2%), local hormone (44.5%) or local non-hormonal (36.5%) therapy. At the time of our investigation 266 of them (97.1%) still had the disorder. CONCLUSIONS: GSM is a common, under-diagnosed and under-treated disorder. Measures to improve its early detection and its appropriate management are needed. SN - 1873-4111 UR - https://www.unboundmedicine.com/medline/citation/26421474/Vaginal_atrophy_of_women_in_postmenopause__Results_from_a_multicentric_observational_study:_The_AGATA_study_ DB - PRIME DP - Unbound Medicine ER -