Diagnosis and management of symptoms associated with vulvovaginal atrophy: expert opinion on behalf of the Italian VVA study group^*

References

• MacBride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc 2010;85:87–94
   PubMed Web of Science ®Google Scholar
• Sturdee DW, Panay N, International Menopause Society Writing Group. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric 2010;13:509–22
   PubMed Web of Science ®Google Scholar
• Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause 2008;15:661–6
   PubMed Web of Science ®Google Scholar
• Giraldi A, Rellini AH, Pfaus J, Laan E. Female sexual arousal disorders. J Sex Med 2013;10:58–73
   PubMed Web of Science ®Google Scholar
• Palacios S, Mejía A, Neyro JL. Treatment of the genitourinary syndrome of menopause. Climacteric 2015;Suppl 1:23–9
   Web of Science ®Google Scholar
• Portman DJ, Gass ML. Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause 2014;21:1063–8
   PubMed Web of Science ®Google Scholar
• Nappi RE, Kokot-Kierepa M. Women’s voices in the menopause: results from an international survey on vaginal atrophy. Maturitas 2010;67:233–8
   PubMed Web of Science ®Google Scholar
• Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views & Attitudes (VIVA) – results from an international survey. Climacteric 2012;15:36–44
   PubMed Web of Science ®Google Scholar
• Kingsberg SA, Wysocki S, Magnus L, Krychman ML. Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE [REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs] survey. J Sex Med 2013;10:1790–9
   PubMed Web of Science ®Google Scholar
• DiBonaventura M, Luo X, Moffatt M, et al. The association between vulvovaginal atrophy symptoms and quality of life among postmenopausal women in the United States and Western Europe. J Womens Health [Larchmt] 2015;24:713–22
   PubMed Web of Science ®Google Scholar
• Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER [CLarifying Vaginal Atrophy’s Impact On SEx and Relationships] survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med 2013;10:2232–41
   PubMed Web of Science ®Google Scholar
• Nappi RE, Palacios S, Panay N, et al. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric 2015;19:10–1
   Web of Science ®Google Scholar
• Parish SJ, Nappi RE, Krychman ML, et al. Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. Int J Womens Health 2013;5:437–47
   PubMedGoogle Scholar
• Nappi RE, Palacios S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric 2014;17:3–9
   PubMed Web of Science ®Google Scholar
• Panay N, Fenton A. Vulvovaginal atrophy – a tale of neglect. Climacteric 2014;17:1–2
   Web of Science ®Google Scholar
• [NAMS] Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause 2013;20:888–902
   PubMed Web of Science ®Google Scholar
• Neves-e-Castro M, Birkhauser M, Samsioe G, et al. EMAS position statement: The ten point guide to the integral management of menopausal health. Maturitas 2015;81:88–92
   PubMed Web of Science ®Google Scholar
• Palacios S, Castelo-Branco C, Currie H, et al. Update on management of genitourinary syndrome of menopause: a practical guide. Maturitas 2015;82:308–13
   PubMed Web of Science ®Google Scholar
• Palacios S, Mejias A. An update on drugs for the treatment of menopausal symptoms. Expert Opin Pharmacother 2015;16:2437–47
   PubMed Web of Science ®Google Scholar
• Bachmann GA, Cheng RJ, Rovner E. Vulvovaginal complaints. In: Lobo RA, ed. Treatment of the postmenopausal woman: basic and clinical aspects. 3rd ed. Burlington (MA): Academic Press; 2007:263–70
   Google Scholar
• Palma F, Volpe A, Villa P, Cagnacci A, as the writing group of the AGATA study. Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: the AGATA study. Maturitas 2016;83:40–4
   PubMed Web of Science ®Google Scholar
• Bachmann G. Urogenital ageing: an old problem newly recognized. Maturitas 1995;Suppl. 1:S1–5
   Google Scholar
• Huang AJ, Gregorich SE, Kuppermann M, et al. Day-to-Day Impact of Vaginal Aging questionnaire: a multidimensional measure of the impact of vaginal symptoms on functioning and well-being in postmenopausal women. Menopause 2015;22:144–54
   PubMed Web of Science ®Google Scholar
• Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med 2009;6:2133–42
   PubMed Web of Science ®Google Scholar
• Utian WH, Maamari R. Attitudes and approaches to vaginal atrophy in postmenopausal women: a focus group qualitative study. Climacteric 2013;17:29–36
   PubMed Web of Science ®Google Scholar
• Nappi RE, Liekens G, Brandenburg U. Attitudes, perceptions and knowledge about the vagina: the International Vagina Dialogue Survey. Contraception 2006;73:493–500
   PubMed Web of Science ®Google Scholar
• Hinchliff S, Gott M. Seeking medical help for sexual concerns in mid- and later life: a review of the literature. J Sex Res 2011;48:106–17
   PubMed Web of Science ®Google Scholar
• Nappi RE, Cucinella L. Advances in pharmacotherapy for treating female sexual dysfunction. Expert Opin Pharmacother 2015;16:875–87
   PubMed Web of Science ®Google Scholar
• Castelo-Branco C, Biglia N, Nappi RE, et al. Characteristics of post-menopausal women with genitourinary syndrome of menopause: implications for vulvovaginal atrophy diagnosis and treatment selection. Maturitas 2015;81:462–9
   PubMed Web of Science ®Google Scholar
• Biglia N, Peano E, Sgandurra P, et al. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study. Gynecol Endocrinol 2010;26:404–12
   PubMed Web of Science ®Google Scholar
• Lee YK, Chung HH, Kim JW, et al. Vaginal pH-balanced gel for the control of atrophic vaginitis among breast cancer survivors: a randomized controlled trial. Obstet Gynecol 2011;117:922–7
   PubMed Web of Science ®Google Scholar
• Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas 1996;23:259–63
   PubMed Web of Science ®Google Scholar
• Nachtigall LE. Comparative study: Replens versus local estrogen in menopausal women. Fertil Steril 1994;61:178–80
   PubMed Web of Science ®Google Scholar
• Dezzutti CS, Brown ER, Moncla B, et al. Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PLoS One 2012;7:e48328
   PubMedGoogle Scholar
• Brown JM, Hess KL, Brown S, et al. Intravaginal practices and risk of bacterial vaginosis and candidiasis infection among a cohort of women in the United States. Obstet Gynecol 2013;121:773–80
   PubMed Web of Science ®Google Scholar
• Edwards D, Panay N. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric 2015;26:1–11
   Google Scholar
• Portman D, Palacios S, Nappi RE, Mueck AO. Ospemifene, a non-estrogen selective estrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial. Maturitas 2014;78:91–8
   PubMed Web of Science ®Google Scholar
• Senshio. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/002780/WC500182778.pdf [last accessed March 2016]
   Google Scholar
• Sinha A, Ewies AA. Non-hormonal topical treatment of vulvo-vaginal atrophy: an up-to-date overview. Climacteric 2013;16:305–12
   PubMed Web of Science ®Google Scholar