Kingsberg Sheryl A, Krychman Michael, Graham Shelli, Bernick Brian, Mirkin Sebastian
University Hospitals Cleveland Medical Center, MacDonald Women's Hospital, Cleveland, OH, USA.
Southern California Center for Sexual Health and Survivorship Medicine Inc, Newport Beach, CA, USA.
J Sex Med. 2017 Mar;14(3):413-424. doi: 10.1016/j.jsxm.2017.01.010. Epub 2017 Feb 12.
Vulvar and vaginal atrophy (VVA) affects up to two thirds of postmenopausal women, but most symptomatic women do not receive prescription therapy.
To evaluate postmenopausal women's perceptions of VVA and treatment options for symptoms in the Women's EMPOWER survey.
The Rose Research firm conducted an internet survey of female consumers provided by Lightspeed Global Market Insite. Women at least 45 years of age who reported symptoms of VVA and residing in the United States were recruited.
Survey results were compiled and analyzed by all women and by treatment subgroups.
Respondents (N = 1,858) had a median age of 58 years (range = 45-90). Only 7% currently used prescribed VVA therapies (local estrogen therapies or oral selective estrogen receptor modulators), whereas 18% were former users of prescribed VVA therapies, 25% used over-the-counter treatments, and 50% had never used any treatment. Many women (81%) were not aware of VVA or that it is a medical condition. Most never users (72%) had never discussed their symptoms with a health care professional (HCP). The main reason for women not to discuss their symptoms with an HCP was that they believed that VVA was just a natural part of aging and something to live with. When women spoke to an HCP about their symptoms, most (85%) initiated the discussion. Preferred sources of information were written material from the HCP's office (46%) or questionnaires to fill out before seeing the HCP (41%).The most negative attributes of hormonal products were perceived risk of systemic absorption, messiness of local creams, and the need to reuse an applicator. Overall, HCPs only recommended vaginal estrogen therapy to 23% and oral hormone therapies to 18% of women. When using vaginal estrogen therapy, less than half of women adhered to and complied with posology; only 33% to 51% of women were very to extremely satisfied with their efficacy.
The Women's EMPOWER survey showed that VVA continues to be an under-recognized and under-treated condition, despite recent educational initiatives. A disconnect in education, communication, and information between HCPs and their menopausal patients remains prevalent. Kingsberg S, Krychman M, Graham S, et al. The Women's EMPOWER Survey: Identifying Women's Perceptions on Vulvar and Vaginal Atrophy and Its Treatment. J Sex Med 2017;14:413-424.
外阴和阴道萎缩(VVA)影响多达三分之二的绝经后女性,但大多数有症状的女性未接受处方治疗。
在女性赋权调查中评估绝经后女性对VVA及其症状治疗选择的看法。
罗斯研究公司对Lightspeed Global Market Insite提供的女性消费者进行了一项网络调查。招募了至少45岁、报告有VVA症状且居住在美国的女性。
调查结果由所有女性及治疗亚组进行汇总和分析。
受访者(N = 1858)的年龄中位数为58岁(范围 = 45 - 90岁)。目前仅有7%的人使用处方VVA疗法(局部雌激素疗法或口服选择性雌激素受体调节剂),而18%曾是处方VVA疗法的使用者,25%使用非处方治疗,50%从未使用过任何治疗。许多女性(81%)不了解VVA或不知道这是一种疾病状况。大多数从未使用者(72%)从未与医疗保健专业人员(HCP)讨论过她们的症状。女性不与HCP讨论症状的主要原因是她们认为VVA只是衰老的自然一部分,是一种需要忍受的情况。当女性与HCP谈论她们的症状时,大多数(85%)发起了讨论。首选的信息来源是HCP办公室的书面材料(46%)或看HCP之前要填写的问卷(41%)。激素产品最负面的属性被认为是全身吸收的风险、局部乳膏的脏乱以及需要重复使用涂抹器。总体而言,HCP仅向23%的女性推荐阴道雌激素疗法,向18%的女性推荐口服激素疗法。使用阴道雌激素疗法时,不到一半的女性坚持并遵循用药剂量;只有33%至51%的女性对其疗效非常满意至极满意。
女性赋权调查显示,尽管最近开展了教育倡议,但VVA仍然是一种未得到充分认识和治疗的疾病状况。HCP与其绝经患者之间在教育、沟通和信息方面的脱节仍然普遍存在。金斯伯格S、克里奇曼M、格雷厄姆S等。女性赋权调查:确定女性对外阴和阴道萎缩及其治疗方法的看法。《性医学杂志》2017年;第14卷:413 - 424页。