Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey

Abstract

Objectives The aim of the European REVIVE survey was to achieve a better understanding of vulvovaginal atrophy (VVA), a chronic and progressive condition after menopause. We investigated perceptions, experiences and needs in terms of sexual and vaginal health in a sample of European postmenopausal women.

Methods An online internet based survey was conducted in Italy, Germany, Spain and the UK with a total surveyed sample of 3768 postmenopausal women (age: 45–75 years).

Results The most common VVA symptom was vaginal dryness (70%). VVA has a significant impact on the ability to be intimate (62%), to enjoy sexual intercourse (72%) and to feel sexual spontaneity (66%). Postmenopausal women with VVA are sexually active (51%), but their sexual drive is reduced. Health-care professionals (HCPs) have discussed VVA with postmenopausal women (62%), but they initiated the conversation only in 10% of the cases. The most common treatments for VVA are over-the-counter, non-hormonal, local vaginal products. Thirty-two per cent of postmenopausal women were naïve to any kind of treatment, whereas discussion with the HCP was relevant to be on current treatment (60% of postmenopausal women that discussed VVA with a HCP vs. 23% who did not). The top reasons for poor compliance with vaginal treatments were: not bothersome enough symptoms (18%); vaginal changes not therapeutically reversed (18%); relief from VVA symptoms (17%). Approximately 45% were satisfied with treatment. The most frequent disliked aspects of treatment were the route of administration or the messiness. The fear of hormones was common in postmenopausal women using vaginal prescription products.

Conclusions The European REVIVE survey confirmed that VVA symptoms are frequent in postmenopausal women and demonstrates a significant impact on quality of life and sexual life. However, the condition is still under-diagnosed and under-treated, with a high rate of dissatisfaction for actual available treatments in the four European countries surveyed. The discussion of symptoms with HCPs seems the most critical factor for diagnosis and treatment of VVA.

KEYWORDS:

• Vulvar and vaginal atrophy
• postmenopausal women
• REVIVE Survey
• Europe
• sexual relationships
• vaginal dryness
• dyspareunia
• treatment

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Acknowledgements

The authors would like to thank Emili González-Pérez (TFS Develop), Scientific Advisor and Medical Writer, for his assistance with manuscript preparation. Sponsorship and article processing charges for this study were funded by Shionogi, Inc.

Conflict of interest

Rossella E. Nappi had a financial relationship (lecturer, member of advisory boards and/or consultant) with Bayer HealthCare AG, Boehringer Ingelheim, Ely Lilly, Gedeon Richter, HRA Pharma, Merck Sharpe & Dohme, Novo Nordisk, Pfizer Inc, Procter & Gamble Co, Shionogi Limited and TEVA Women’s Health Inc. Santiago Palacios has been a symposium speaker or advisory board member for Servier, Pfizer, GSK, Abbott, Ferrer, Bioiberica, Shionogi, Amgen, Novo Nordisk and Teva. He has also received research grants and/or consulting fees from Pfizer, Servier, Amgen, MSD, Preglem, Leon Farma, Gynea, Sandoz, Procare Health and Bayer. Nick Panay has received honoraria for lecturing and acting in an advisory capacity for a number of pharma companies including Abbott, Bayer, Besins, Novo Nordisk, Pfizer and Shionogi. Martire Particco is an employee of Shionogi Italy. Michael L. Krychman received financial support or consulting fees from Shionogi Inc, Pfizer, Palatin, Noven Therapeutics, Materna and Viveve Medical. He receives support for his speakers’ bureau activities from Noven Therapeutics, Pfizer and Shionogi.

Source of funding

Financial support for the REVIVE Survey was provided by Shionogi Limited.