Macro-regional variation in attitudes toward and experiences of vulvar and vaginal atrophy among Italian post-menopausal women: a post hoc analysis of REVIVE survey data

Abstract

Italian participants in the European REVIVE survey reported that vaginal and vulvar atrophy (VVA) impaired various aspects of their lives, notably the ability to enjoy sex. The aim of the present study was to explore regional differences in knowledge, experiences, and treatment of VVA in the Italian REVIVE sample (n ¼ 1000), which was analyzed according to region of residence. While many respondents were unfamiliar with the VVA condition, most could relate their VVA symptoms to the menopause. The rate of diagnosis of VVA was twice as high in Central Italy as in the North-East. For individual VVA symptoms, 25.4-41.6% of respondents judged that the symptom had worsened over time. There were no significant regional differences for symptoms in terms of reported rate, change in severity, impact on sexual activity, or health-care visits. Testosterone cream and OTC medication based on hyaluronic acid showed significant regional differences in lifetime rates of use. In Italy, there are modest regional differences in knowledge, diagnosis, and treatment of VVA, some of which may be explained by inter-regional differences in health care. Further efforts are needed to ensure that Italian women are properly informed about VVA and have access to appropriate health care and treatments.

Impact of vulvovaginal atrophy of menopause: prevalence and symptoms in Italian women according to the EVES study

“…Second, and in line with the overall EVES study [12], our data in Italy show that the presence of VVA symptoms in postmenopausal women visiting a gynecology/menopause clinic is clearly higher than other studied populations cohorts; however, vaginal dryness, pain during intercourse and burning are the most subjective reported VVA symptoms across studies. In this sense, the REVIVE survey experience evaluating regional differences in Italy in terms of VVA symptoms [14] found no regional variances in most of them. Thus, country-specific approaches may be required to better distinguish patterns rather that regional population differences within a country.…”

“…The main objective of the current study is to focus on the evaluation of the VVA presence in postmenopausal women confirmed even by a clinical assessment in the Italian population. The previous REVIVE experience in Europe (including Italy) evaluating attitudes and perceptions toward VVA used an online-based evaluation [13,14]. So, the current study including an individual survey together with a confirmatory gynecological examination provides a differential and innovative value for the characterization of this population of Italian postmenopausal women.…”

Knowledge of genito-urinary syndrome of menopause among Italian gynecologists: the DIADEM survey

“…Previous studies of Italian post-menopausal women under local hormonal treatment show that 51 % were satisfied with the treatment [9], while data collected from American women report a higher adherence (59 %) and satisfaction (67 %) with ospemifene compared to vaginal creams or the estradiol ring [8]. This difference may be due to cultural differences in symptoms and treatment perception [6,24]. However, inadequate perception of women's preferences and treatment efficacy by gynecologists cannot be excluded possibly due to the lack of appropriate follow-up of the responses to treatments.…”

“…Respondent mostly worked in hospitals and private clinics (Table 1). The median years of experience of respondents (defined as number of years from specialization) was 25 (13− 31) (men 29 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) years; women 21 (11-30) years, p < 0.001). Sixty-four percent of participants reported 10-40 visits/month of post-menopausal women while 67 %, 10-40 visits/month of peri-menopausal women (Table 1).…”

Comparison of the effect of noninvasive radiofrequency with vaginal estrogen and vaginal moisturizer in the treatment of vulvovaginal atrophy in postmenopausal women: a randomized clinical trial

“…4,[6][7][8][9][10] Among the wide range of VVA symptoms, vaginal dryness is the most common, reported by more than 83% of postmenopausal women depending on the study, followed by dyspareunia (38%-59%) and vulvovaginal irritation (37%-77%). 8,[11][12][13][14][15] Vaginal estrogens are considered the gold standard treatment for moderate and severe VVA symptoms. 4 The biological effects of estrogens on the atrophic vaginal mucosa include decreased pH, increased superficial cells, decreased parabasal cells (improved cell maturation), and improved clinical symptoms of VVA.…”