Prevalence of vulvovaginal atrophy and its impact on quality of life in women. The issues of terminology and the safety of local hormone therapy


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Symptoms of vulvovaginal atrophy (VVA), such as vaginal dryness, burning, itching, and discomfort, painful and burning urination, dyspareunia, and bloody vaginal discharge during sexual intercourse, disturb as high as 57% of postmenopausal women. But despite the wide prevalence and dramatic progression of this condition, required therapy is performed in about 25% of women in western countries and in much fewer women in others. One of the reasons for the existing situation is that the patients are unaware of the high efficiency and safety of local treatment for VVA.

Full Text

Restricted Access

About the authors

Angelina Vladislavovna Glazunova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: lianochka185@yandex.ru
postgraduate of gynecological endocrinology department

Svetlana Vladimirovna Yureneva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: syureneva@gmail.com
MD

References

  1. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013; 20(9): 888-902. quiz 903-4.
  2. Lindau S.T., Schumm L.P., Laumann E.O., Levinson W., O’Muircheartaigh C.A., Waite L.J. A study of sexuality and health among older adults in the United States. N. Engl. J. Med. 2007; 357(8): 762-74.
  3. Santoro N., Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J. Sex. Med. 2009; 6: 2133-42.
  4. Santiago Palacios. Managing urogenital atrophy. Maturitas. 2009; 63: 315-8.
  5. Frank S.M., Ziegler C., Kokot-Kierepa M., Maamari R., Nappi R.E. Vaginal health: insights, views & attitudes (VIVA) survey - Canadian cohort. Menopause Int. 2012; Nov 30.
  6. Simon J.A., Kokot-Kierepa M., Goldstein J., Nappi R.E. Vaginal health in the United States: results from the Vaginal Health: Insights, Views & Attitudes survey. Menopause. 2013; 20(10): 1043-8. doi: 0.1097/GME.0b013e318287342d.
  7. Kingsberg S.A., Wysocki S., Magnus L., Krychman M.L. Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (Real Women_s Views of Treatment Options for Menopausal Vaginal Changes) survey. J. Sex. Med. 2013; 10(7): 1790-9. doi: 10.1111/jsm.12190.
  8. Sturdee D.W., Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010; 13: 509-22.
  9. Kingsberg S.A., Krychman M.L. Resistance and barriers to local estrogen therapy in women with atrophic vaginitis. J. Sex. Med. 2013; 10(6): 1567-74.
  10. Nappi R.E., Kokot-Kierepa M. Women’s voices in the menopause: results from an international survey on vaginal atrophy. Maturitas. 2010; 7(3): 233-8.
  11. Wyeth REVEAL: Revealing vaginal effects at mid-life: Surveys of postmenopausal women and health care professionals who treat postmenopausal women. Madison, NJ: Wyeth; 2009. Available at: http://www.revealsurvey.com/pdf/ reveal-survey-results.pdf. Accessed February 21, 2013.
  12. Адамян Л.В., Курило Л.Ф., Глыбина Т.М., Окулов А.Б. Аномалии развития органов женской репродуктивной системы: новый взгляд на морфогенез. Проблемы репродукции. 2009; 4: 10-9. [Adamyan L.V., Kurilo L.F., Glybina T.M., Okulov A.B. Abnormalities of the development of female reproductive system: a new perspective on morphogenesis. Problems of reproduction. 2009; 4: 10-9. In Russ.]
  13. Есефидзе Ж.Т. Клинико-патогенетические особенности вагинальной атрофии в постменопаузе: автореф. дис.. канд. мед. наук. М.; 2002. [Esefidze Zh.T. Clinical and pathogenetic features of vaginal atrophy in postmenopausal women. Diss. M.; 2002. In Russ.]
  14. Bachmann G., Bouchard C., Hoppe D., Ranganath R., Altomare C., Vieweg A. et al. Efficacy and safety of low-dose regimens of conjugated estrogens cream administered vaginally. Menopause. 2009; 16(4): 719-27.
  15. Балан В.Е. Урогенитальные расстройства в климактерии (клиника, диагностика, заместительная гормонотерапия): дис.. д-ра мед. наук. М.; 1998. [Balan V.E. Urogenital disorders in menopause (clinic, diagnostics, hormone replacement therapy). Diss. M.; 1998. In Russ.]
  16. Lee J.S., Ettinger B., Stanczyk F.Z., Vittinghoff E., Hanes V., Cauley J.A. et al. Comparison of methods to measure low serumestradiol levels in postmenopausal women. J. Clin. Endocrinol. Metab. 2006; 91: 3791-7.
  17. Naessen T., Rodriguez-Macias K. Endometrial thickness and uterine diameter not affected by ultralow doses of 17beta-estradiol in elderly women. Am. J. Obstet. Gynecol. 2002; 186(5): 944-7.
  18. Eugster-Hausmann M., Waitzinger J., LehnickD. Minimized estradiol absorption with ultra-low-dose 10 μg 17β-estradiol vaginal tablets. Climacteric. 2010; 13 (3): 219-27.
  19. Rigg L.A., Hermann H., Yen S.S. Absorption of estrogens from vaginal creams. N. Engl. J. Med. 1978; 298(4): 195-7.
  20. Santen R.J., Pinkerton J.V., Conaway M., Ropka M., Wisniewski L., Demers L., Klein K. O. Treatment of urogenital atrophy with low-dose estradiol: preliminary results. Menopause. 2002; 9(3): 179-87.
  21. Handa V.L., Bachus K.E., Johnston W.W., Robboy S.J., Hammond C.B. Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium. Obstet. Gynecol. 1994; 84(2): 215-8.
  22. Bunyavejchevin S., Veeranarapanich S. Quality of life assessment in Thai postmenopausal women with an overactive bladder. J. Med. Assoc. Thai. 2005; 88(8): 1023-7.
  23. Burgio K.L. Behavioral treatment options for urinary incontinence. Gastroenterology. 2004; 126(1, Suppl. 1): S82-9.
  24. Harman S.M., Black D.M., Naftolin F., Brinton E.A., Budoff M.J., Cedars M.I. et al. Arterial imaging outcomes and cardiovascular risk factors in recently menopausal women: a randomized trial. Ann. Intern. Med. 2014; 161(4): 249-60.
  25. Grady D., Vittinghoff E., Lin F., Hanes V., Ensrud K., Habel L.A. et al. Effect of ultra-low-dose transdermal estradiol on breast density in postmenopausal women. Menopause. 2007; 14(3, Pt 1): 391-6.
  26. Lyytinen H., Pukkala E., Ylikorkala O. Breast cancer risk in postmeno pausal women using estrogen-only therapy. Obstet. Gynecol. 2006; 108(6): 1354-60.
  27. Anderson G.L., Chlebowski R. T., Aragaki A.K., Kuller L.H., Manson J.E., Gass M. et al. Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women’s Health Initiative randomised placebo-controlled trial. Lancet Oncol. 2012; 13(5): 476-86.
  28. Manson J.E., Chlebowski R.T., Stefanick M.L., Aragaki A.K., Rossouw J.E., Prentice R.L. et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013; 310(13): 1353-68.
  29. Biglia N., Peano E., Sgandurra P., Moggio G., Panuccio E., Migliardi M. et al. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study. Gynecol. Endocrinol. 2010; 26(6): 404-12.
  30. Kendall A., Dowsett M., Folkerd E., Smith I. Caution: Vaginal estradiol appears to be contraindicated in postmenopausal women on adjuvant aromatase inhibitors. Ann. Oncol. 2006; 17(4): 584-7.
  31. Le Ray I., DellAniello S., Bonnetain F., Azoulay L., Suissa S. Local estrogen therapy and risk of breast cancer recurrence among hormonetreated patients: a nested case-control study. Breast Cancer Res. Treat. 2012; 135: 603-9.
  32. Wills S., Ravipati A., Venuturumilli P., Kresge C., Folkerd E., Dowsett M. et al. Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator. J. Oncol. Pract. 2012; 8(3): 144-8.
  33. Col N.F., Kim J.A., Chleboskwi R.T. Menopausal hormone therapy after breast cancer: a meta-analysis and critical appraisal of the evidence. Breast Cancer Res. 2005; 7(4): R535-40.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies