Clinician Knowledge, Attitudes, and Barriers to Management of Vulvovaginal Atrophy

Variations in Primary Care and Gynecology

Kimberly K. Vesco, MD, MPH; Kate Beadle, NP, NCMP; Ashley Stoneburner, MPH; Joanna Bulkley, PhD; Michael C. Leo, PhD; Amanda L. Clark, MD, MCR, NCMP


Menopause. 2019;26(3):265-272. 

In This Article


Primary care and gynecology clinicians differ in their knowledge and confidence in managing vulvovaginal atrophy but report similar practice barriers. Addressing identified knowledge deficits and practice barriers may lead to improved management of vulvovaginal atrophy. Additional work related to improving the recognition and treatment of VVA could include national initiatives such as advocating for changes in Medicare coverage, revising the package insert for vaginal estrogen products,[32] and public health campaigns to increase women's awareness that VVA symptoms are not just an unavoidable aspect of aging. Increased public awareness of GSM symptoms and treatment options and improved access to menopause care could empower women to talk about their genitourinary health with peers and clinicians and to seek treatment for symptoms.