Palacios S, Cancelo M J, Castelo Branco C, Llaneza P, Molero F, Borrego R Sanchez
a Instituto Palacios de Salud y Medicina de la Mujer , Madrid , Spain.
b Department of Obstetrics and Gynecology , Hospital Universitario de Guadalajara , Guadalajara , Spain.
Climacteric. 2017 Feb;20(1):55-61. doi: 10.1080/13697137.2016.1262840. Epub 2017 Jan 2.
To gain a deeper comprehension of current vulvovaginal atrophy (VVA) knowledge among Spanish postmenopausal women.
An online survey (REVIVE) was conducted in four European countries with an overall sample of 768 participants included in Spain. Perceptions, experiences and needs of Spanish postmenopausal women in terms of sexual and vaginal health were reported.
Vaginal dryness was the most common VVA symptom in Spain (81%). The severity of symptoms reported by postmenopausal women tended to be similar or worse than at onset, especially in the most troublesome symptom, dyspareunia (80%). VVA symptoms significantly impact on Spanish participants' ability to achieve sexual enjoyment (75%), relationship with partner (67%) and sexual spontaneity (66%). Although 71% of participants with partners (83%) were sexually active, their sex drive was reduced by one-third as a consequence of VVA. Despite the fact that women expected doctors to start asking them about menopausal symptoms, this rarely occurred. Treatments were administered mainly vaginally without prescription (62% were using over-the-counter products at the time). Postmenopausal women who had discussed their symptoms with physicians were twice as likely to be treated (66% vs. 33%) than those who had not. Low compliance with treatment was justified by Spanish participants with not bothersome enough symptoms (22%), relief (21%), inability to reverse vaginal changes (15%) and treatment price (13%). Almost half of the participants with a current local estrogen prescription showed satisfaction. The acknowledged main limitation for all treatments was the inability to restore the natural conditions of the vagina. The price of over-the-counter products was also reported as an important concern in Spanish postmenopausal women.
VVA remains underdiagnosed and undertreated in Spain, despite its high frequency and significant impact on quality of life. Since patient satisfaction with available treatments remains compromised, an effective discussion of symptoms and therapies with doctors would improve its management.
更深入了解西班牙绝经后女性对当前外阴阴道萎缩（VVA）的认知情况。
在四个欧洲国家开展了一项在线调查（REVIVE），西班牙共有768名参与者纳入总体样本。报告了西班牙绝经后女性在性健康和阴道健康方面的认知、经历及需求。
阴道干涩是西班牙最常见的VVA症状（81%）。绝经后女性报告的症状严重程度往往与发病时相似或更严重，尤其是在最困扰人的症状性交困难方面（80%）。VVA症状对西班牙参与者获得性愉悦的能力（75%）、与伴侣的关系（67%）以及性自发性（66%）有显著影响。尽管71%有伴侣的参与者（83%）仍有性生活，但VVA导致她们的性欲降低了三分之一。尽管女性期望医生开始询问她们的更年期症状，但这种情况很少发生。治疗主要通过非处方阴道用药（62%的人当时使用非处方产品）。与医生讨论过症状的绝经后女性接受治疗的可能性是未讨论过的女性的两倍（66%对33%）。西班牙参与者认为治疗依从性低的原因是症状不够困扰（22%）、症状缓解（21%）、无法逆转阴道变化（15%）和治疗价格（13%）。目前使用局部雌激素处方的参与者中近一半表示满意。公认的所有治疗方法的主要局限性是无法恢复阴道的自然状态。非处方产品的价格也是西班牙绝经后女性关注的一个重要问题。
在西班牙，尽管VVA发病率高且对生活质量有重大影响，但仍存在诊断不足和治疗不足的情况。由于患者对现有治疗方法的满意度仍然不高，与医生就症状和治疗方法进行有效的讨论将改善其管理。
