|November 2010 · Vol. 22, No. 11
Only 20% to 25% of women who experience symptoms of vaginal atrophy will seek treatment for them, despite the availability of safe and effective treatment options
James A. Simon, MD
Clinical Professor, Department of Obstetrics and Gynecology, George Washington University, Medical Director, Women’s Health & Research Consultants, Washington, DC
The author is a consultant for Abbott, Allergan, Alliance for Better Bone Health, Amgen, Ascend Therapeutics, Azur Pharma, Bayer, BioSante, Boehringer Ingelheim, Concert Pharmaceuticals, Corcept Therapeutics, Depomed, Fabre-Kramer, GlaxoSmithKline, Graceway Pharmaceuticals, KV, Laboratoire HRA Pharma, Lipocine, Meditrina Pharmaceuticals, Merck, Merrion Pharmaceuticals, Nanma/Tripharma/Trinity, NDA Partners, Novo Nordisk, Novogyne, Pear Tree Pharmaceuticals, QuatRx Pharmaceuticals, Roche, Schering-Plough, Sciele, Solvay, Teva, Ther-Rx, Warner Chilcott, and Wyeth; receives grants/research support from Bio-Sante, Boehringer Ingelheim, FemmePharma, GlaxoSmithKline, Nanma/Tripharma/Trinity, Novartis, Procter and Gamble, QuatRx Pharmaceuticals, and Teva; and is a speaker for Amgen, Ascend, Bayer, Boehringer Ingelheim, GlaxoSmithKline, KV, Merck, Novartis, Novogyne, Novo Nordisk, Sciele, Teva, Ther-Rx, Warner Chilcott, and Wyeth.
The female vaginal tract relies on estrogen stimulation to maintain normal structure and function. After menopause, estrogen deficiency results in vaginal atrophy and its manifestations, including vaginal dryness, irritation, and burning; dyspareunia; and an increased risk of urinary tract infections. These symptoms and disorders are common, progressive, and unlikely to resolve without treatment. However, only 20% to 25% of women who experience these symptoms will ultimately seek treatment for them,1,2 despite the availability of safe and effective treatment options, including local low-dose vaginal estrogen therapy.
In this supplement to OBG Management, four experts in menopausal health consider the latest evidence on the pathogenesis, diagnosis, and treatment of vaginal atrophy and its symptoms. In the first article, JoAnn Pinkerton, MD, considers the epidemiology, pathogenesis, evaluation, and diagnosis of vaginal atrophy, and in the second article, Risa Kagan, MD, reviews the therapeutic options used to treat vaginal atrophy and its symptoms. Michael Krychman, MD, evaluates its impact on postmenopausal quality of life and sexuality in the third article, and, in the final article of the supplement, Steven R. Goldstein, MD, considers the safety and tolerability of low-dosage local vaginal estrogen therapy.
We hope the information contained in the supplement will be useful and will assist you in your efforts to recognize, diagnose, and manage vaginal atrophy and its symptoms in your patients.
1. North American Menopause Society. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. Menopause. 2007;14(3 Pt 1):355–369.
2. Pandit L, Ouslander JG. Postmenopausal vaginal atrophy and atrophic vaginitis. Am J Med Sci. 1997;314(4):228–231.
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