title: Diagnosis and management of symptoms associated with vulvovaginal atrophy: expert opinion on behalf of the Italian VVA study group.
abstract: Vulvovaginal atrophy (VVA) is a chronic disorder that commonly occurs in postmenopausal women, whose symptoms are recognized among the most frequent and bothersome symptoms associated with menopause. The principal therapeutic goal in managing VVA is to relieve symptoms as well as to restore the vaginal environment to a healthy state. However, despite its high prevalence and negative impact on quality of life, VVA is underreported by women, underrecognized by gynecologists, and therefore, undertreated. In the light of the new development of treatment options for VVA, we here provide an updated expert opinion on the management of VVA. In particular, we strongly recommend that HCPs proactively start an open discussion with their postmenopausal patients about urogenital symptoms. Treatment should be started as early as the first symptoms of VVA occur and should be maintained over time, due to the chronicity of the conditions. Many treatment options are now available and therapy should be individualized, taking the woman's preference in consideration.
authors.affiliation: a Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia , Pavia , Italy.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.affiliation: b Obstetrics and Gynecology, University of Turin, School of Medicine Ospedale Mauriziano Umberto I , Turin , Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.affiliation: c Gynecology and Obstetrics, University of Modena and Reggio Emilia, Azienda Policlinico of Modena , Modena , Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cagnacci
authors.affiliation: d Gynecology and Obstetrics, Department of Neurosciences and Reproductive Sciences, University of Naples Federico II , Naples , Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.affiliation: e Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Policlinico "Le Scotte" , Siena , Italy , and.
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.affiliation: f Obstetrics and Gynecology, Department of Surgical Sciences, University of Cagliari , AOU Cagliari , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paoletti
mesh_terms: D001284:Atrophy / Q000175:diagnosis / Q000188:drug therapy; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007558:Italy; D017698:Postmenopause; D014623:Vaginal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D014845:Vulvar Diseases / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D004967:Estrogens
keywords: Diagnosis; VVA; expert opinion; management; vulvovaginal atrophy