Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women.

Vaginal dryness and discomfort is common in the menopause. As is pain on intercourse. Unfortunately, most women do not mention it to their doctors, and just suffer in silence. Treatment is effective – either oestrogen in HRT or oestrogen as a pessary or vaginal cream. This study shows that treatment is best and more effective if started early, rather than when the problem has been there for a while.

Maturitas. 2019 Jun;124:55-61. doi: 10.1016/j.maturitas.2019.03.013. Epub 2019 Mar 18.

Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women.

Panay N1, Palacios S2, Bruyniks N3, Particco M4, Nappi RE5; EVES Study investigators.

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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.


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.


Association between treatments for VVA and symptom frequency.


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.


Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic ( orally or transdermal) 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.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on November 22, 2020, in Uncategorized. Bookmark the permalink. Comments Off on Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women..

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