Vulvar and vaginal atrophy as viewed by the Spanish REVIVE participants: symptoms, management and treatment perceptions

Abstract

Objectives: To gain a deeper comprehension of current vulvovaginal atrophy (VVA) knowledge among Spanish postmenopausal women.

Methods: An online survey (REVIVE) was conducted in four European countries with an overall sample of 768 participants included in Spain. Perceptions, experiences and needs of Spanish postmenopausal women in terms of sexual and vaginal health were reported.

Results: Vaginal dryness was the most common VVA symptom in Spain (81%). The severity of symptoms reported by postmenopausal women tended to be similar or worse than at onset, especially in the most troublesome symptom, dyspareunia (80%). VVA symptoms significantly impact on Spanish participants’ ability to achieve sexual enjoyment (75%), relationship with partner (67%) and sexual spontaneity (66%). Although 71% of participants with partners (83%) were sexually active, their sex drive was reduced by one-third as a consequence of VVA. Despite the fact that women expected doctors to start asking them about menopausal symptoms, this rarely occurred. Treatments were administered mainly vaginally without prescription (62% were using over-the-counter products at the time). Postmenopausal women who had discussed their symptoms with physicians were twice as likely to be treated (66% vs. 33%) than those who had not. Low compliance with treatment was justified by Spanish participants with not bothersome enough symptoms (22%), relief (21%), inability to reverse vaginal changes (15%) and treatment price (13%). Almost half of the participants with a current local estrogen prescription showed satisfaction. The acknowledged main limitation for all treatments was the inability to restore the natural conditions of the vagina. The price of over-the-counter products was also reported as an important concern in Spanish postmenopausal women.

Conclusion: VVA remains underdiagnosed and undertreated in Spain, despite its high frequency and significant impact on quality of life. Since patient satisfaction with available treatments remains compromised, an effective discussion of symptoms and therapies with doctors would improve its management.

Keywords:

• Vulvar and vaginal atrophy
• postmenopausal women
• REVIVE survey
• Spain
• sexual relationships
• vaginal dryness
• dyspareunia
• treatment

Conflict of interest

Dr Santiago Palacios had a financial relationship (lecturer, member of advisory boards and/or consultant) with Pfizer, Servier, Amgen, MSD, Preglem, Gynea, Sandoz, Procare Health, Bayer, MSD, Serelys and Shionogi. He has also been a symposium speaker or advisory board member and has received research grants and/or consulting fees from Servier, Pfizer, GSK, Abbott, Ferrer, Bioiberica, Shionogi, Amgen, Novo Nordisk, Teva, Bayer Healthcare, Serelys and Gedeon Ritcher. Dr Mª Jesús Cancelo has been a symposium speaker or advisory board member for Shionogi, Amgen, Grünenthal and MSD. Dr Camil Castelo-Branco had a financial relationship (lecturer, member of advisory boards and/or consultant) with Shionogi, Pierre-Fabre and Gedeon Richter. He has been a symposium speaker for Shionogi, Pierre Fabre, Grünenthal and Innuo. Dr Plácido Llaneza has been a symposium speaker or advisory board member for Shionogi, Merck Serono, TEVA, Amgen, Italfármaco and Seid. Dr Rafael Sanchez Borrego had a financial relationship (lecturer, member of advisory board and/or consultant) with 100% Natural, Seid, Procare Health, MSD, Shionogi, Exeltis and Bial. Dr Francisca Molero had a financial relationship (member of advisory boards and/or consultant) with Shionogi and Litaphar. She has been a symposium speaker for Shionogi, Lilly, Isdin and Gedeon Ritcher.

Source of funding

Financial support for this study was provided by Shionogi S. L. U.