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Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women.
Maturitas. 2019 Jun; 124:55-61.M

Abstract

OBJECTIVES

To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women.

STUDY DESIGN

Cross-sectional survey conducted in postmenopausal women aged 45-75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale - revised (FSDS-R) were filled out.

MAIN OUTCOME MEASURES

Association between treatments for VVA and symptom frequency.

RESULTS

Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p < 0.0005). The systemic hormone group presented with fewer VVA symptoms, lower vaginal impact (DIVA), and better sexual function (FSFI and FSDS-R) and vaginal health. The rates of sexual distress and vulvar atrophy were higher in the non-hormonal treatment group. No significant differences were found according to treatment duration.

CONCLUSIONS

Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments. Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman.

Authors+Show Affiliations

Imperial College London, UK. Electronic address: nickpanay@msn.com.Palacios Institute of Women's Health, Madrid, Spain.BrInPhar Ltd. Iver Heath, UK.Shionogi Ltd, London. UK.Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31097180

Citation

Panay, Nick, et al. "Symptom Severity and Quality of Life in the Management of Vulvovaginal Atrophy in Postmenopausal Women." Maturitas, vol. 124, 2019, pp. 55-61.
Panay N, Palacios S, Bruyniks N, et al. Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women. Maturitas. 2019;124:55-61.
Panay, N., Palacios, S., Bruyniks, N., Particco, M., & Nappi, R. E. (2019). Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women. Maturitas, 124, 55-61. https://doi.org/10.1016/j.maturitas.2019.03.013
Panay N, et al. Symptom Severity and Quality of Life in the Management of Vulvovaginal Atrophy in Postmenopausal Women. Maturitas. 2019;124:55-61. PubMed PMID: 31097180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women. AU - Panay,Nick, AU - Palacios,Santiago, AU - Bruyniks,Nico, AU - Particco,Martire, AU - Nappi,Rossella E, AU - ,, Y1 - 2019/03/18/ PY - 2018/11/23/received PY - 2019/03/12/revised PY - 2019/03/15/accepted PY - 2019/5/18/entrez PY - 2019/5/18/pubmed PY - 2019/7/31/medline KW - Hormonal treatment KW - Non-hormonal treatment KW - Postmenopause KW - Quality of life KW - Sexual function KW - Vulvovaginal atrophy SP - 55 EP - 61 JF - Maturitas JO - Maturitas VL - 124 N2 - OBJECTIVES: To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women. STUDY DESIGN: Cross-sectional survey conducted in postmenopausal women aged 45-75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale - revised (FSDS-R) were filled out. MAIN OUTCOME MEASURES: Association between treatments for VVA and symptom frequency. RESULTS: Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p < 0.0005). The systemic hormone group presented with fewer VVA symptoms, lower vaginal impact (DIVA), and better sexual function (FSFI and FSDS-R) and vaginal health. The rates of sexual distress and vulvar atrophy were higher in the non-hormonal treatment group. No significant differences were found according to treatment duration. CONCLUSIONS: Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments. Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman. SN - 1873-4111 UR - https://www.unboundmedicine.com/medline/citation/31097180/Symptom_severity_and_quality_of_life_in_the_management_of_vulvovaginal_atrophy_in_postmenopausal_women_ DB - PRIME DP - Unbound Medicine ER -