title: Vaginal Health: Insights, Views & Attitudes (VIVA) survey - Canadian cohort.
abstract: OBJECTIVE
  To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey.
  
  
  METHODS
  An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK, the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented (n = 500).
  
  
  RESULTS
  Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), 'having a loving relationship with a partner' (39%) and 'overall quality of life' (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams).
  
  
  CONCLUSIONS
  These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options.
authors.affiliation: Temple Green Clinic, Waterloo, Ontario, Canada.
authors.forename: Sheldon M
authors.initials: SM
authors.lastname: Frank
authors.affiliation: Sir Mortimer B Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Cleve
authors.initials: C
authors.lastname: Ziegler
authors.affiliation: Novo Nordisk Health Care AG, Zurich, Switzerland.
authors.forename: Marta
authors.initials: M
authors.lastname: Kokot-Kierepa
authors.affiliation: Novo Nordisk Inc, 100 College Road West, Princeton, NJ 08540, USA riom@novonordisk.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Maamari
authors.affiliation: Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Department of Obstetrics and Gynecology, IRCCS 'S Matteo Foundation', University of Pavia, Pavia, Italy.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi