title: Iranian postmenopausal women's experiences of treatment of symptomatic vulvovaginal atrophy.
abstract: OBJECTIVE
  Our aim was to explore the experiences of Iranian postmenopausal women who sought medical help for their symptomatic vulvovaginal atrophy (VVA).
  
  
  METHODS
  Five focus group discussions (FGDs) were conducted. Participants had to be postmenopausal; had bothersome symptoms of VVA for which they came to the clinic; had previously sought medical help for their VVA; and had confirmed physical signs of VVA upon examination by a gynecologist.
  
  
  RESULTS
  Twenty-five women, aged 49-60 years participated in the five FGDs. Twenty women said they currently had >1 VVA symptom at presentation to the clinic. Four major themes emerged from the women's narrative stories: (1) negative impact of VVA on women's life, (2) psychological distress associated with VVA, (3) negative impact of VVA on marriage and relationship, (4) inadequate symptom relief from available treatments due to lack of awareness of VVA treatment options. None of the participants reported ongoing treatment of their VVA with local low-dose estrogen. Women further commented that, although local estrogen products were costly, they would like to use them if they were prescribed.
  
  
  CONCLUSIONS
  Considering the negative impact of VVA symptoms on women's lives, health professionals in Iran should be prescribing approved and effective therapies for symptomatic women.
authors.affiliation: a Department of Reproductive Health , Mazandaran University of Medical Sciences , Sari , Iran.
authors.forename: E
authors.initials: E
authors.lastname: Fooladi
authors.affiliation: b Department of Pelvic Floor , Imam Khomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: M
authors.initials: M
authors.lastname: Deldar
authors.affiliation: c Department of Reproductive Health , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: F
authors.initials: F
authors.lastname: Mohammadzadeh
authors.affiliation: d Department of Reproductive Health , Shahroud University of Medical Sciences , Shahrud , Iran.
authors.forename: E
authors.initials: E
authors.lastname: Ahmadnia
authors.affiliation: a Department of Reproductive Health , Mazandaran University of Medical Sciences , Sari , Iran.
authors.forename: S
authors.initials: S
authors.lastname: Khani
authors.affiliation: b Department of Pelvic Floor , Imam Khomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Ghanbari
mesh_terms: D001284:Atrophy / Q000188:drug therapy / Q000523:psychology; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007492:Iran; D008875:Middle Aged; D017698:Postmenopause; D011788:Quality of Life; D012725:Sexual Behavior / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology; D014621:Vagina / Q000473:pathology*; D014844:Vulva / Q000473:pathology*
chemical_list: D004967:Estrogens
keywords: Vulvovaginal atrophy; postmenopausal women; sexual distress; vaginal dryness