Vulvar and Vaginal Atrophy Undertreated in Postmenopausal Women

A survey of almost 2000 postmenopausal women showed that women's knowledge of treatment options for VVA remains low.

Postmenopausal women with vulvar and vaginal atrophy (VVA) are uninformed and undertreated for the condition, researchers reported at the North American Menopause Society (NAMS) 2016 Annual Meeting.

Michael Krychman, MD, of the Center for Sexual Health and Survivorship Medicine in Southern California, and colleagues conducted the Women’s EMPOWER survey, an assessment of postmenopausal women’s knowledge about VVA. Current EMPOWER results were compared with results of past VVA surveys—REVEAL (Revealing Vaginal Effects at Mid-Life), VIVA US (Vaginal Health: Insight, Views, and Attitudes-US and International), Healthy Women #1, REVIVE (Real Women’s Views of Treatment Options for Menopausal Vaginal Changes-US and EU), CLOSER (Clarifying Vaginal Atrophy’s Impact on Sex and Relationships-North America and EU), and Healthy Women #2—in an effort to assess progress in participants’ understanding of VVA.

The internet-based survey was completed by 1858 postmenopausal women throughout the United States who had symptoms of VVA. Dr Krychman and colleagues found that results of the EMPOWER survey were consistent with past VVA surveys.

Eighty-one percent of participants were not aware that VVA is a chronic medical condition; comparatively, the REVEAL survey showed that 43% of participants were not aware of the link between VVA symptoms and menopause. A majority of participants (90%) in the VIVA survey who were experiencing vaginal symptoms failed to attribute the symptoms to VVA, while 43% failed to recognize VVA as a chronic condition.

More than two-thirds of EMPOWER respondents were unfamiliar with most prescription VVA products, despite significant marketing and educational efforts intended to spread awareness of the condition and its treatments.

“Women generally failed to recognize VVA and its chronic, progressive course and were reluctant to discuss vaginal or sexual symptoms with their health care providers,” the researchers wrote.

Participants who took the CLOSER survey were more likely to use prescription therapy (31%) than those who participated in the EMPOWER survey (7%). Participants in the REVIVE survey indicated that, among currently available treatments, there was a perceived lack of efficacy (69%) and prohibitive cost (32%); concerns regarding hormone safety and exposure were a top reason why 76% of respondents did not like the currently available vaginal estrogen preparations.

“The results of the Women’s EMPOWER survey demonstrate and reinforce that, even with multimedia marketing and educational strategies in the years after other major VVA surveys, minimal progress has been made toward increasing awareness and understanding of VVA,” said Dr Krychman in a press release. “Women remain naïve to the safe and effective treatment options that are currently available and are still, for the most part, underinformed and undertreated.”

Disclosures: This study was funded by TherapeuticsMD. Dr Krychman reports relationships with Sermonix Pharmaceuticals, Shionogi Inc, New England Research Institutes, and Pfizer.

For more coverage of NAMS 2016, click here.

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  1. Krychman M, Kingsberg S, Graham S, Bernick B, Mirkin S, Constantine G. Abstract P-71The EMPOWER survey: women’s knowledge and treatment of vulvar and vaginal atrophy (VVA) remains low years after previous survey. Presented at: North American Menopause Society (NAMS) 2016 Annual Meeting; October 5-8, 2016; Orlando, FL.
  2. Despite major consumer marketing and educational efforts, new survey shows women still don’t understand why sex hurts after menopause [press release]. Cleveland, OH: North American Society (NAMS) Press Room; October 5, 2016. Accessed October 7, 2016.