The American–European difference in vulvar and vaginal atrophy views: a lesson from the REVIVE Survey

ABSTRACT

Vulvar and vaginal atrophy (VVA) is a common complaint in postmenopausal women and consists of a variety of symptoms and strong repercussions that negatively affect comfort during sexual activity and ultimately impact quality of life. The EU and US REVIVE surveys have detected significant barriers in health-care professional management and educational programs that prevent correct diagnosis and effective treatment. This was common in both Europe and the US, but differential behaviors and patterns could be detected after reviewing the published results. The frequency of reporting VVA symptoms was lower in European participants. However, a better knowledge that VVA is a consequence of menopause was evident in Europe, probably in relation to more frequent gynecological visits and more frequent specialist visits as a referral health-care professional. Moreover, a trend towards an improved satisfaction with management by the health-care professional was observed in Europe. European participants acknowledged a significantly higher impact of VVA symptoms on sexual intercourse and partner interaction than North American (US) participants, and both cohorts were observed to have differences between their respective VVA symptom profiles. These observations have implications in the overall concerns that participants stated with long-term VVA medication and for the optimal therapeutic approach, providing evidence to support the concept that unexplored methods to improve management of patients with VVA remain.

KEYWORDS:

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

Acknowledgements

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

Conflict of interest

Rossella E. Nappi has 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, TEVA Women’s Health Inc. Michael L. Krychman received financial support for consulting fees from Shionogi Inc, Pfizer, Palatin, Noven Therapeutics, Materna, Viveve Medical and Sprout Pharmaceuticals. He receives support for his speakers’ bureau activities from Noven Therapeutics, Pfizer and Shionogi.

Source of funding

Sponsorship and article processing charges for this study were funded by Shionogi Ltd. Financial support for the REVIVE Survey was provided by Shionogi Ltd.