title: Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey.
abstract: BACKGROUND
  Vulvar and vaginal atrophy (VVA) is a chronic medical condition experienced by many postmenopausal women. Symptoms include dyspareunia (pain with intercourse), vaginal dryness, and irritation and may affect sexual activities, relationships, and activities of daily life.
  
  
  OBJECTIVE
  The aim of this study is to characterize postmenopausal women's experience with and perception of VVA symptoms, interactions with healthcare professionals (HCPs), and available treatment options.
  
  
  METHODS
  An online survey was conducted in the United States in women from KnowledgePanel(®) , a 56,000-member probability-selected Internet panel projectable to the overall US population. Altogether, 3,046 postmenopausal women with VVA symptoms (the largest US cohort of recent surveys) responded to questions about their knowledge of VVA, impact of symptoms on their activities, communication with HCPs, and use of available treatments.
  
  
  METHODS
  Percent is calculated as the ratio of response over total responding for each question for all and stratified participants.
  
  
  RESULTS
  The most common VVA symptoms were dryness (55% of participants), dyspareunia (44%), and irritation (37%). VVA symptoms affected enjoyment of sex in 59% of participants. Additionally, interference with sleep, general enjoyment of life, and temperament were reported by 24%, 23%, and 23% of participants, respectively. Few women attributed symptoms to menopause (24%) or hormonal changes (12%). Of all participants, 56% had ever discussed VVA symptoms with an HCP and 40% currently used VVA-specific topical treatments (vaginal over-the-counter [OTC] products [29%] and vaginal prescription therapies [11%]). Of those who had discussed symptoms with an HCP, 62% used OTC products. Insufficient symptom relief and inconvenience were cited as major limitations of OTC products and concerns about side effects and cancer risk limited use of topical vaginal prescription therapies.
  
  
  CONCLUSIONS
  VVA symptoms are common in postmenopausal women. Significant barriers to treatment include lack of knowledge about VVA, reluctance to discuss symptoms with HCPs, safety concerns, inconvenience, and inadequate symptom relief from available treatments.
authors.affiliation: Department of Reproductive Biology, Case Western University, Cleveland, OH, USA. Sheryl.kingsberg@uhhospitals.org
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Kingsberg
authors.forename: Susan
authors.initials: S
authors.lastname: Wysocki
authors.forename: Leslie
authors.initials: L
authors.lastname: Magnus
authors.forename: Michael L
authors.initials: ML
authors.lastname: Krychman
mesh_terms: D001284:Atrophy; D004414:Dyspareunia / Q000188:drug therapy / Q000473:pathology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012725:Sexual Behavior; D014481:United States; D014621:Vagina / Q000473:pathology*; D014623:Vaginal Diseases / Q000188:drug therapy / Q000473:pathology / Q000523:psychology; D014844:Vulva / Q000473:pathology*; D014845:Vulvar Diseases / Q000188:drug therapy / Q000473:pathology / Q000523:psychology
keywords: Dyspareunia; Postmenopausal Women; Sexual Relationships; Survey; Vaginal Dryness; Vulvar and Vaginal Atrophy