title: The REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey in Europe: Country-specific comparisons of postmenopausal women's perceptions, experiences and needs.
abstract: OBJECTIVE
  To achieve a better comprehension of the variability of perceptions, experiences and needs in terms of sexual and vaginal health in postmenopausal women (PMW) from four different European countries.
  
  
  METHODS
  An internet-based survey was conducted in Italy, Germany, Spain and the United Kingdom with a total surveyed population of 3768 PMW aged between 45 and 75 years.
  
  
  RESULTS
  The UK sample was significantly older, with almost a quarter of participants over 65 years of age, and had the highest proportion of women experiencing recent vulvar and vaginal atrophy (52.8%). The majority of Italian and Spanish participants were receiving VVA treatment, whereas in the UK only 28% of PMW were on medication. The most common menopausal symptom was vaginal/vulvar dryness, with almost 80% of participants reporting it in all the countries except the UK (48%). On the other hand, vaginal/vulvar irritation was more frequently reported in the UK (41%). The percentage of participants with a partner was lower in the UK (71%), as was the monthly rate of sexual activity (49%). In the UK, the proportion of participants who had seen a healthcare professional for gynaecological reasons in the last year was lower than in other countries (27% vs. ≥50%), as was the proportion who has discussed their VVA symptoms with them (45% vs. ∼67%). In this sense, UK PMW waited for a longer before asking for help (especially for pain with intercourse and dryness). The main issues relating to VVA treatment difficulties expressed by participants were administration route in the UK, efficacy in Germany, and side-effects in Italy.
  
  
  CONCLUSIONS
  Although all European women shared the same expectation of improving the quality of their sex lives, the opportunity for that varied among different countries in relation to the healthcare system and to the effective communication achieved with healthcare professionals when managing VVA.
authors.affiliation: Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept. of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy. Electronic address: renappi@tin.it.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.affiliation: Palacios Institute of Women's Health, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Palacios
authors.affiliation: Shionogi Italy, Rome, Italy.
authors.forename: Martire
authors.initials: M
authors.lastname: Particco
authors.affiliation: Imperial College London, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Panay
mesh_terms: D000368:Aged; D001284:Atrophy; D005060:Europe; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014621:Vagina / Q000473:pathology*; D014623:Vaginal Diseases / Q000523:psychology*; D014844:Vulva / Q000473:pathology*
keywords: Dyspareunia; Europe; Postmenopausal women; REVIVE survey; Sexual relationships; Treatment; Vaginal dryness; Vulvar and vaginal atrophy