title: Macro-regional variation in attitudes toward and experiences of vulvar and vaginal atrophy among Italian post-menopausal women: a post hoc analysis of REVIVE survey data.
abstract: Italian participants in the European REVIVE survey reported that vaginal and vulvar atrophy (VVA) impaired various aspects of their lives, notably the ability to enjoy sex. The aim of the present study was to explore regional differences in knowledge, experiences, and treatment of VVA in the Italian REVIVE sample (n = 1000), which was analyzed according to region of residence. While many respondents were unfamiliar with the VVA condition, most could relate their VVA symptoms to the menopause. The rate of diagnosis of VVA was twice as high in Central Italy as in the North-East. For individual VVA symptoms, 25.4-41.6% of respondents judged that the symptom had worsened over time. There were no significant regional differences for symptoms in terms of reported rate, change in severity, impact on sexual activity, or health-care visits. Testosterone cream and OTC medication based on hyaluronic acid showed significant regional differences in lifetime rates of use. In Italy, there are modest regional differences in knowledge, diagnosis, and treatment of VVA, some of which may be explained by inter-regional differences in health care. Further efforts are needed to ensure that Italian women are properly informed about VVA and have access to appropriate health care and treatments.
authors.affiliation: a Department of Clinical, Surgical, Diagnostic and Paediatric Sciences , Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, University of Pavia , Pavia , Italy.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.affiliation: b Shionogi Italy , Rome , Italy.
authors.forename: Martire
authors.initials: M
authors.lastname: Particco
authors.affiliation: c Department of Obstetrics and Gynaecology , University of Torino School of Medicine, Ospedale Mauriziano Umberto I , Torino , Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.affiliation: d Department of Obstetrics and Gynecology , University of Modena , Modena , Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cagnacci
authors.affiliation: e 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: f Department of Molecular and Developmental Medicine, Obstetrics and Gynecology Unit , University of Siena , Siena , Italy , and.
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.affiliation: g Department of Obstetrics and Gynaecology , University of Cagliari, University Hospital of Cagliari , Cagliari , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paoletti
mesh_terms: D000368:Aged; D001284:Atrophy; D005260:Female; D005843:Geography; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D010465:Perception; D017698:Postmenopause / Q000523:psychology*; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014621:Vagina / Q000473:pathology*; D014623:Vaginal Diseases / Q000453:epidemiology / Q000523:psychology; D014844:Vulva / Q000473:pathology*; D014845:Vulvar Diseases / Q000453:epidemiology / Q000523:psychology
keywords: Dyspareunia; Italian post-menopausal women; REVIVE survey; sexual relationships; vaginal dryness; vulvar and vaginal atrophy