title: Spanish consensus on vulvar disorders in postmenopausal women.
abstract: BACKGROUND
  The consequences of vulvar disorders in terms of health, sexuality, and quality of life are usually undervalued, with disparities in the conceptual, diagnosis and treatment criteria.
  
  
  OBJECTIVE
  The objective of this guide will be to analyse the factors associated with the diagnosis and treatment of vulvar disorders and to provide recommendations for the most appropriate diagnostic and therapeutic measures.
  
  
  METHODS
  A panel of experts from various Spanish scientific societies related to sexual health (Spanish Menopause Society [SMS] and the Asociación Española de Patología Cervical y Colposcopia [AEPCC]) met to reach a consensus on these issues and to decide the optimal timing and methods based on the best evidence available.
  
  
  RESULTS
  We recommend a biopsy of all vulvar lesions with an uncertain diagnosis, especially with asymmetry, irregular borders, variegated and irregular colour and diameter >6mm. For vulvodynia, we recommend the use of lubricants or topical treatments with lidocaine or bupivacaine, amitriptyline, baclofen or triamcinolone. For vulvar epithelial disorders, we recommend beginning with topical corticosteroids of moderate to high potency. For sexual dysfunction, a multidisciplinary approach is the best management strategy in these patients.
authors.affiliation: University of Cadiz, Spain. Electronic address: rcominod@sego.es.
authors.forename: Rafael
authors.initials: R
authors.lastname: Comino
authors.affiliation: Complutense University of Madrid, Spain. Electronic address: pcoronadom@gmail.com.
authors.forename: Pluvio J
authors.initials: PJ
authors.lastname: Coronado
authors.affiliation: Dexeus, Barcelona, Spain. Electronic address: 16978mct@comb.cat.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Cararach
authors.affiliation: University of Murcia, Spain. Electronic address: anibal.nieto@hotmail.com.
authors.forename: Anibal
authors.initials: A
authors.lastname: Nieto
authors.affiliation: University of Alicante, Spain. Electronic address: martinez_jca@gva.es.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Martinez-Escoriza
authors.affiliation: University of Granada, Granada, Spain. Electronic address: asalaman@ugr.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Salamanca
authors.affiliation: University of Granada, Granada, Spain. Electronic address: lmtorresg5@hotmail.com.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Torres-Garcia
authors.affiliation: Complutense University of Madrid, Spain. Electronic address: jvidarta@sego.es.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Vidart
authors.affiliation: University of Granada, Granada, Spain. Electronic address: nicomendoza@telefonica.net.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Mendoza
authors.affiliation: Hospital Clinic, Barcelona, Spain. Electronic address: aureli@comb.es.
authors.forename: Aureli
authors.initials: A
authors.lastname: Torne
authors.affiliation: Clínica Diatros, Barcelona, Spain. Electronic address: rschez.borrego@diatros.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sánchez-Borrego
mesh_terms: D001284:Atrophy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy*; D032921:Consensus; D005260:Female; D006801:Humans; D017698:Postmenopause; D011788:Quality of Life; D060728:Reproductive Health; D012955:Societies, Medical; D013030:Spain; D014844:Vulva / Q000473:pathology*; D014845:Vulvar Diseases / Q000175:diagnosis / Q000628:therapy*; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000628:therapy*; D056650:Vulvodynia / Q000175:diagnosis / Q000628:therapy
keywords: Postmenopausal symptoms; Sexual health; Vulvar skin disorders; Vulvodynia