Imperial College London, UK.
Palacios Institute of Women's Health, Madrid, Spain.
Maturitas. 2019 Jun;124:55-61. doi: 10.1016/j.maturitas.2019.03.013. Epub 2019 Mar 18.
To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women.
Cross-sectional survey conducted in postmenopausal women aged 45-75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale - revised (FSDS-R) were filled out.
Association between treatments for VVA and symptom frequency.
Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p < 0.0005). The systemic hormone group presented with fewer VVA symptoms, lower vaginal impact (DIVA), and better sexual function (FSFI and FSDS-R) and vaginal health. The rates of sexual distress and vulvar atrophy were higher in the non-hormonal treatment group. No significant differences were found according to treatment duration.
Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments. Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman.
评估治疗外阴阴道萎缩（VVA）与绝经后妇女阴道症状频率和严重程度、生活质量（QoL）和性功能之间的关系。
对 45-75 岁绝经后妇女进行横断面调查。收集人口统计学和临床变量以及阴道、外阴和尿症状的数据。填写欧洲生活质量五维问卷（EQ5D3L）、阴道衰老日常影响量表（DIVA）、女性性功能指数（FSFI）和女性性功能障碍简表修订版（FSDS-R）。
VVA 治疗与症状频率之间的关系。
接受 VVA 治疗的女性症状更严重。治疗组的性功能评分更高（FSFI：15.6 对 16.7；p=0.010），性困扰评分也更高（FSDS-R：9.2 对 12.3，p<0.0005）。全身激素组 VVA 症状较少，阴道影响较小（DIVA），性功能（FSFI 和 FSDS-R）和阴道健康较好。非激素治疗组性困扰和外阴萎缩的发生率较高。治疗持续时间无显著差异。
患有 VVA 并接受治疗的绝经后妇女比未接受治疗的妇女报告的症状更严重。与其他治疗方法相比，接受全身治疗的女性 VVA 症状更少且更轻微，阴道和外阴健康状况更好。许多女性在 VVA 症状已经很严重时才要求有效的局部治疗。我们的数据表明，VVA 治疗应在症状开始并引起困扰时进行，而不是在症状可能变得更严重甚至成为女性无法忍受的困扰时进行。
