Nappi R E, Krychman M L
a Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences , University of Pavia , Pavia , Italy ;
b Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, and Department of Obstetrics and Gynecology , University of California-Irvine , Irvine , CA , USA.
Climacteric. 2016 Jun;19(3):252-5. doi: 10.3109/13697137.2016.1173026. Epub 2016 Apr 20.
Vulvar and vaginal atrophy (VVA) is a common complaint in postmenopausal women and consists of a variety of symptoms and strong repercussions that negatively affect comfort during sexual activity and ultimately impact quality of life. The EU and US REVIVE surveys have detected significant barriers in health-care professional management and educational programs that prevent correct diagnosis and effective treatment. This was common in both Europe and the US, but differential behaviors and patterns could be detected after reviewing the published results. The frequency of reporting VVA symptoms was lower in European participants. However, a better knowledge that VVA is a consequence of menopause was evident in Europe, probably in relation to more frequent gynecological visits and more frequent specialist visits as a referral health-care professional. Moreover, a trend towards an improved satisfaction with management by the health-care professional was observed in Europe. European participants acknowledged a significantly higher impact of VVA symptoms on sexual intercourse and partner interaction than North American (US) participants, and both cohorts were observed to have differences between their respective VVA symptom profiles. These observations have implications in the overall concerns that participants stated with long-term VVA medication and for the optimal therapeutic approach, providing evidence to support the concept that unexplored methods to improve management of patients with VVA remain.
外阴和阴道萎缩（VVA）是绝经后女性的常见问题，由多种症状组成，会产生强烈影响，对性行为时的舒适度产生负面影响，并最终影响生活质量。欧盟和美国的REVIVE调查发现，在医疗保健专业人员的管理和教育项目中存在重大障碍，阻碍了正确诊断和有效治疗。这在欧洲和美国都很常见，但在审查已发表的结果后，可以发现不同的行为和模式。欧洲参与者报告VVA症状的频率较低。然而，在欧洲，人们更清楚地认识到VVA是绝经的结果，这可能与更频繁的妇科就诊以及作为转诊医疗保健专业人员更频繁地看专科医生有关。此外，在欧洲观察到对医疗保健专业人员管理的满意度有提高的趋势。欧洲参与者承认VVA症状对性交和伴侣互动的影响明显高于北美（美国）参与者，并且观察到两个队列各自的VVA症状特征存在差异。这些观察结果对参与者表示的对VVA长期用药的总体担忧以及最佳治疗方法具有影响，为支持仍有未探索的改善VVA患者管理方法这一概念提供了证据。
