Vulvovaginal atrophy: current and future therapies (CME).
BACKGROUND
Vulvovaginal atrophy results from estrogen deficiency and affects a large number of postmenopausal women. Symptoms include vaginal dryness, itching, irritation, and dyspareunia.


OBJECTIVE
The purpose of this review is to evaluate the efficacy, safety and acceptability of current treatment methods for vulvovaginal atrophy, as well as highlight evolving new treatment methods. Method. We conducted a review of the literature concerning treatment of vulvovaginal atrophy.


RESULTS
All currently available low-dose local estrogen formulations are effective and yield few side effects. Fears sparked by the Women's Health Initiative, as well as recommendations by the FDA, have generated interest in the development of new treatment methods. Lower doses of existing formulations have proven to be efficacious. The use of estrogen agonists/antagonists and intravaginal dehydroepiandrosterone (DHEA) have both been shown to positively affect vaginal atrophy symptoms without inducing endometrial proliferation.


CONCLUSIONS
Potential new treatment methods show promise to provide efficacy in treatment while avoiding unwanted side effects. Further research is needed to establish optimal treatment formulations.
Ibe
Comfort
C
George Washington University Medical Center-Obstetrics and Gynecology, Washington, DC 20036, USA.
Simon
James A
JA
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000368:Aged; D001284:Atrophy / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D003687:Dehydroepiandrosterone / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004358:Drug Therapy / Q000639:trends*; D004414:Dyspareunia / Q000453:epidemiology / Q000517:prevention & control; D004967:Estrogens / Q000008:administration & dosage / Q000172:deficiency / Q000627:therapeutic use*; D005260:Female; D052776:Female Urogenital Diseases / Q000188:drug therapy / Q000453:epidemiology; D005544:Forecasting; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D014848:Vulvovaginitis / Q000188:drug therapy* / Q000453:epidemiology*
D000276:Adjuvants, Immunologic; D004967:Estrogens; D003687:Dehydroepiandrosterone