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12 October 2010
New treatment recommendations for vaginal atrophy

The International Menopause Society is launching new recommendations for the management of postmenopausal vaginal atrophy, a distressing condition that will affect up to half of all women after menopause.

The new guidelines note that one-in-two women with vaginal atrophy will live with their condition unnecessarily for over three years, despite effective treatments being available. The data suggests that this is largely due to poor awareness and understanding of the condition among women, and because it is a "taboo" subject - even between a doctor and patient.

Vaginal atrophy is characterized by vaginal dryness, itching, increased tendency of infection and pain during sex. It occurs when the vaginal walls become thin, fragile and inflamed due to a reduction of estrogen in the body.

If left untreated, vaginal atrophy can lead to serious long-term urogenital problems, including incontinence. However, despite these negative implications, only 25 percent of affected women will actually speak to their doctor. "It is unacceptable that women are living with vaginal atrophy for so long, when various safe and effective treatments are available. Women with vaginal atrophy are also encouraged to seek medical advice, as there is absolutely no need for them to continue suffering in silence," said Dr David Sturdee, President of the International Menopause Society.

The recommendations note that many women may not report vaginal atrophy symptoms to their doctor because of concerns about taking hormone replacement therapy (HRT). Some of this reluctance is due to the adverse publicity for HRT over recent years, but, regardless of whether these concerns are justified, local estrogen therapy for vaginal atrophy, which delivers a low dose of hormone directly to the vagina, is not associated with the possible risks of systemic HRT. Doctors need to ensure patients fully understand this, so that they can benefit from vaginal atrophy treatment.

In addition, women with vaginal atrophy may have cultural or religious reasons for not talking to their doctor about their symptoms, and women in general may be understandably reluctant to discuss such private matters, particularly with a male doctor. The new recommendations offer advice and guidance to healthcare professionals, to enable them to initiate a successful dialogue with their patient. Most women express relief and respond positively when a doctor initiates the conversation about this topic.

Vaginal atrophy is not an inevitable part of menopause so it is vital that a dialogue about vaginal health is initiated by doctors with postmenopausal patients, the recommendations urge.

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Source: International Menopause Society

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