Advances in the Treatment of Vulvovaginal Atrophy

Jill M Krapf; Zoe R Belkin; Andrew T Goldstein

Disclosures

Expert Rev of Obstet Gynecol. 2013;8(5):457-465. 

In This Article

Abstract and Introduction

Abstract

Vulvovaginal atrophy is a frequently neglected symptom of menopause. While an estimated 10–40% of women are affected by the progressive symptoms of vaginal dryness, irritation, itching, dysuria and dyspareunia, only a quarter of symptomatic women are believed to seek medical attention. Until recently, treatments for vulvovaginal atrophy were limited to often insufficient or inappropriate oral estrogen therapies and over-the-counter lubricants and moisturizers. Currently, a broader range of treatments, which address symptom reduction and estrogen restoration to affected tissue, are being developed. Among these treatments are local estrogen, selective estrogen receptor modulators, tissue-selective estrogen complexes, local androgens, dehydroepiandrosterone, oxytocin, phytoestrogens and nonhormonal options. The aim of this article is to discuss current treatments for vulvovaginal atrophy. In addition, we will discuss alternative therapies and explore emerging strategies for care.

Introduction

Vulvovaginal atrophy is often described as a 'silent symptom' of menopause. While an estimated 10–40% of postmenopausal women are affected, only 25% of symptomatic women seek medical attention. This condition, which can have a large impact on quality of life and sexual function, is often underdiagnosed and undertreated. Unlike vasomotor symptoms of menopause, which typically abate over time, vulvovaginal symptoms are usually progressive and less likely to resolve without effective treatment.[1,2]

Treatment approaches for vulvovaginal atrophy focus on symptom reduction and restoration of affected tissues. Options for care range from over-the-counter preparations to hormonal therapy.[1,3,4] The aim of this article is to review current treatments for vulvovaginal atrophy. In addition, we will discuss alternative therapies and explore emerging strategies for care.

processing....