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Review
. 2018 Jul 31:10:387-395.
doi: 10.2147/IJWH.S158913. eCollection 2018.

Current treatment options for postmenopausal vaginal atrophy

Iuliia Naumova  1 , Camil Castelo-Branco  2
Affiliations
Review

Current treatment options for postmenopausal vaginal atrophy

Iuliia Naumova et al. Int J Womens Health. .

Abstract

Vulvovaginal atrophy (VVA) is a silent epidemic that affects up to 50%-60% of postmenopausal women who are suffering in silence from this condition. Hormonal changes, especially hypoestrogenism inherent in menopause, are characterized by a variety of symptoms. More than half of menopausal women are concerned about the symptoms of VVA, such as dryness, burning, itching, vaginal discomfort, pain and burning when urinating, dyspareunia, and spotting during intercourse. All these manifestations significantly reduce the quality of life and cause discomfort in the sexual sphere. However, according to research, only 25% of patients with the symptoms of VVA receive adequate therapy. This is probably due to the lack of coverage of this problem in the society and the insufficiently active position of specialists in the field of women's health regarding the detection of symptoms of VVA. Many patients are embarrassed to discuss intimate complaints with a specialist, which makes it difficult to verify the diagnosis in 75% of cases, and some patients regard the symptoms of VVA as manifestations of the natural aging process and do not seek help. Modern medicine has in the arsenal various options for treating this pathological condition, including systemic and topical hormone replacement therapy, the use of selective estrogen receptor modulators, vaginal dehydroepiandrosterone, use of lubricants and moisturizers, as well as non-drug therapies. Timely diagnosis and adequately selected therapy for the main symptoms of VVA lead to restoration and maintenance of the vaginal function and vaginal health.

Keywords: dyspareunia; hormonal replacement therapy; local estrogen; menopause; selective estrogen receptor modulator; vaginal dehydroepiandrosterone; vaginal dryness; vulvovaginal atrophy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Cascade effects of the mechanism of VVA. Abbreviation: VVA, vulvovaginal atrophy.
See this image and copyright information in PMC

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