title: The CLOSER survey: impact of postmenopausal vaginal discomfort on relationships between women and their partners in Northern and Southern Europe.
abstract: OBJECTIVE
  CLOSER investigated how postmenopausal vaginal atrophy ('vaginal discomfort') affects relationships between women and their partners.
  
  
  METHODS
  CLOSER involved postmenopausal women (55-65 years) with vaginal discomfort, and male partners of women with the condition.
  
  
  METHODS
  Structured questionnaire collecting information on impact of vaginal discomfort and local oestrogen treatment on intimacy and relationships, and symptoms and impact of menopause.
  
  
  RESULTS
  1600 women and 1600 men from Northern Europe and 1000 women and 1000 men from Southern Europe were included. Worry that vaginal discomfort would never go away was expressed by 28% and 38% of women in Northern and Southern Europe, respectively (p<0.05), while 21% and 27% worried that vaginal discomfort would ruin their future sex life (p<0.05). Half of women who avoided intimacy worried about painful sex. Among men, 86% wanted their partner to talk about symptoms; two-thirds felt comfortable with this. In Northern and Southern Europe, 15% and 11% of men, respectively, feared that discussing vaginal discomfort would ruin intimacy, while 29% and 19% believed that vaginal discomfort was a big problem in their sex life. Men with partners who avoided intimacy recognised that worry about painful sex was the main reason. Vaginal discomfort impaired self-esteem and emotional wellbeing among women, while local oestrogen treatment improved relationships, particularly in Southern Europe.
  
  
  CONCLUSIONS
  Vaginal discomfort impairs quality of life in postmenopausal women and their partners. Southern European women were generally more worried about long-term effects on their relationship, and were more likely to report benefits after treatment.
authors.affiliation: Research Centre for Reproductive Medicine, University of Pavia, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, Pavia, Italy. renappi@tin.it
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.forename: Lars-Åke
authors.initials: LÅ
authors.lastname: Mattsson
authors.forename: Michèle
authors.initials: M
authors.lastname: Lachowsky
authors.forename: Ricardo
authors.initials: R
authors.lastname: Maamari
authors.forename: Annamaria
authors.initials: A
authors.lastname: Giraldi
mesh_terms: D000368:Aged; D003075:Coitus / Q000523:psychology; D003142:Communication; D004644:Emotions; D004967:Estrogens / Q000627:therapeutic use; D005060:Europe; D005260:Female; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D017698:Postmenopause / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D060728:Reproductive Health; D012649:Self Concept; D012735:Sexual Dysfunction, Physiological / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D014623:Vaginal Diseases / Q000188:drug therapy
chemical_list: D004967:Estrogens
keywords: Local oestrogen therapy; Male partner; Menopause; Relationships; Vaginal atrophy; Vaginal discomfort