Management of vaginal atrophy: a real mess. Results from the AGATA study

Abstract

Objectives: To investigate the management of vaginal atrophy (VA) in a population-based study.

Study design: A sub-study of a cross-sectional multicenter study on 913 postmenopausal women.

Main outcome measures: Management of VA was investigated on the 274 women referring having received a previous diagnosis of VA.

Results: Women had received, no therapy (9.8%), systemic hormones (9.2%), intra-vaginal estrogens (44.5%) or local non-hormonal (36.5%) therapy. There was heterogeneity of treatments. Local therapies were given in cycles, and used for a length of time ranging from 1 to 12 months. At the time of the investigation 59.5% of these women were not on treatment, either because following the physician’s indication (31.1%) or because spontaneously withdrawing from treatment (68.9%). Reasons for withdrawing from therapy were insufficient symptom relief (46.6%), messiness (24.3%), difficulty in application (7.8%) and vaginal discharge (1.9%). At the time of investigation only 2.9% of treated women did not suffer from VA.

Conclusions: This study underlines the presence of a great confusion about the therapy used for VA, along with patients’ dissatisfaction with actual treatments. The emerging evidence is that in real world VA remains untreated.

Chinese abstract

目的：以人群为基础的调查性研究阴道萎缩（VA）的管理。

研究设计：一项913名绝经后妇女的多中心研究的子研究。

主要结局指标：对274名原先诊断为VA的妇女行阴道萎缩管理的调查。

结果：妇女已经接受的处理有：无治疗（9.8％）、全身激素治疗（9.2％）、阴道内雌激素（44.5％）或局部非激素治疗（36.5％）。治疗具有异质性。局部治疗以周期给药, 用药时间为1-12个月。在调查的时候, 这些妇女中有59.5％未在治疗, 为遵医嘱（31.1％）或自发性停止治疗（68.9％）。停止治疗的原因包括症状缓解不佳（46.6%）、杂乱（24.3%）、使用困难（7.8%）和阴道分泌物（1.9%）。调查期间发现已治疗过的女性中仅有2.9%不再遭受阴道萎缩的痛苦。

结论：这项研究强调, 存在阴道萎缩治疗方法的很大混乱, 以及病人对真正治疗不满意。新出现的证据表明, 在实际中, 阴道萎缩仍然未得到治疗。

Keywords:

• Genitourinary syndrome of menopause
• management
• menopause
• vaginal health
• vaginal atrophy

Acknowledgements

Each of the authors significantly contributed to the design and data collection of the study and all authors reviewed and approved the final manuscript. The study was supported by an unrestricted grant of the Italian Society for the Menopause (SIM). None of the writing authors received specific funding for this study.

Declaration of interest

Angelo Cagnacci had served as advisory board member or speaker for MSD, Bayer Italia, Gedeon – Richter, Teva Italia, Zambon Italia, HRA Pharma, Shionogi Italia. None of the other writing authors declare any conflict of interest with the study.