title: Personal opinion: Treatment of vulvovaginal atrophy--are hidden interests and misinformation preventing better management?
abstract: Menopausal women very often complain of vulvovaginal atrophy (VVA)-related symptoms, which mainly include dryness, irritation, dyspareunia and pain. The ideal therapeutic approach is to use systemic or intravaginal estrogen, which has proved to be effective. However, because of safety concerns that were raised after the publication of the Women's Health Initiative data, non-estrogenic and non-hormonal therapies for VVA have been developed and heavily promoted. Many menopause specialists believe that the flow of information on the newer products indicated for VVA seems to include an inaccurate message, which downgrades the use of estrogenic preparations and upgrades modern non-estrogenic therapies. Both media and medical sources have created an atmosphere of exaggerated worries over intravaginal estrogen therapies, which are not substantiated by hard clinical facts.
authors.affiliation: a Sackler School of Medicine, Tel-Aviv University , Tel-Aviv , Israel.
authors.forename: A
authors.initials: A
authors.lastname: Pines
authors.affiliation: b * Solihull Hospital , Birmingham , UK.
authors.forename: D W
authors.initials: DW
authors.lastname: Sturdee
mesh_terms: D001284:Atrophy / Q000150:complications / Q000188:drug therapy; D003142:Communication; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008593:Menopause; D057240:Patient Preference; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D014621:Vagina / Q000473:pathology*; D014844:Vulva / Q000473:pathology*
chemical_list: D004967:Estrogens
keywords: ALTERNATIVE VAGINAL THERAPIES; BREAST CANCER; CARDIOVASCULAR DISEASE; ENDOMETRIAL CANCER; INTRAVAGINAL ESTROGEN; MENOPAUSE; NON-ESTROGENIC THERAPIES; NON-HORMONAL THERAPIES; TOPICAL ESTROGEN; VULVOVAGINAL ATROPHY