The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause

Abstract

Objectives: The primary objective of the European Vulvovaginal Epidemiological Survey (EVES) was to assess, at a country level, the prevalence of postmenopausal women with vulvovaginal atrophy (VVA) confirmed by gynecological clinical assessment among all postmenopausal women attending menopause centers.

Method: Women aged 45–75 years old with their last menstrual period more than 12 months before and who attended menopause or gynecology centers were included. If they had at least one VVA symptom, women filled a number of questionnaires including the EuroQoL-EQ-5D3L and Day-to-Day Impact of Vaginal Aging (DIVA). Then a gynecological examination was performed to confirm the VVA diagnosis.

Results: A total of 2160 evaluable patients were included in the study. VVA was confirmed in 90% of the patients. Compared with patients without confirmed VVA (n = 206), patients with confirmed VVA (n = 1954) were significantly older (p < 0.001), had more severe symptoms (p < 0.001 for vaginal and vulvar symptoms, p < 0.05 for urinary ones) and had a lower quality of life as assessed by EQ-5D3L (p = 0.012) and DIVA (p < 0.001).

Conclusion: VVA is highly prevalent among postmenopausal women. Gynecological clinical assessment of VVA is associated with severe symptoms and impaired quality of life and therefore should be promoted for appropriate clinical assessment and early therapeutic intervention.

Keywords:

• Vulvovaginal atrophy
• prevalence
• menopause
• EQ-5D3L
• DIVA
• gynecological examination

Acknowledgements

The authors would like to thank Emili González-Pérez (TFS Develop), scientific advisor and medical writer, for his assistance with manuscript preparation.

The complete list of the EVES Study investigators is as follows: C. Argudo Prieto (Gijón, Spain), L. Baquedano Mainar (Zaragoza, Spain), A. M. Becorpi (Florence, Italy), P. Benedetti Panici (Rome, Italy), C. Benedetto (Turin, Italy), N. Biglia (Turin, Italy), M. Busacca (Milan, Italy), A. Cagnacci (Modena, Italy), J. Calleja Abu-Amshah (Madrid, Spain), M. J. Cancelo Hidalgo (Guadalajara, Spain), C. Castelo Branco i Flores (Barcelona, Spain), A. Cianci (Catania, Italy), E. Cicinelli (Bari, Italy), P. Coronado Martin (Madrid, Spain), M. Correa Rancel (Santa Cruz de Tenerife, Spain), F. De Seta (Trieste, Italy), C. Di Carlo (Naples, Italy), M. Fernández Abellán (Málaga, Spain), J. M. Fernández Moya (Madrid, Spain), M. Gambacciani (Pisa, Italy), P. García Alfaro (Barcelona, Spain), M. González Fernández (Barcelona, Spain), S. González Rodríguez (Madrid, Spain), M. Guida (Salerno, Italy), E. Iglesias Bravo (Seville, Spain), P. Llaneza Coto (Oviedo, Spain), S. Luisi (Sienna, Italy), M. Manubens Grau (Barcelona, Spain), D. Marchesoni (Udine, Italy), P. Marín Sánchez (El Palmar, Spain), N. Mendoza Ladrón de Guevara (Granada, Spain), R. Nappi (Pavia, Italy), B. Otero García-Ramos (Baracaldo, Spain), A. M. Paoletti (Cagliari, Italy), S. Palacios (Madrid, Spain), A. Pellegrino (Lecco, Italy), J. C. Presa Lorite (Jaén, Spain), V. Remorgida (Genova, Italy), S. Salvatore (Milan, Italy), R. Sánchez Borrego (Barcelona, Spain), S. Sánchez Méndez (Sant Cugat del Vallés, Spain), R. Seracchioli (Bologna, Italy), M. Stomati (Brindisi, Italy), N. Surico (Novara, Italy), F. Vázquez Fernández (Lugo, Spain), P. Villa (Rome, Italy).

Conflict of interest

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.

Rossella E. Nappi had a financial relationship (lecturer, member of advisory boards and/or consultant) with Bayer HealthCare AG, Endoceutics, Gedeon Richter, HRA Pharma, Merck Sharpe & Dohme, Novo Nordisk, Pfizer Inc, Shionogi Limited, TEVA Women’s Health Inc.

Nico Bruyniks is advisor of Shionogi Ltd.

Martire Particco is employee of Shionogi Ltd.

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.

Source of funding

Sponsorship and article processing charges for this study were funded by Shionogi Ltd.