Postmenopausal Vaginal Atrophy Leads to Relationship Problems

Vaginal Atrophy Undertreated, Has Adverse Effect on Relationships

Medscape Medical News from the:
North American Menopause Society (NAMS) 23rd Annual Meeting

Fran Lowry

Dr. James Simon

October 9, 2012 (Orlando, Florida) — Postmenopausal women have higher rates of vaginal atrophy in the United States than in other countries, in large part because they refuse to consider remedies such as local estrogen therapy, according to a survey presented here at the North American Menopause Society (NAMS) 23rd Annual Meeting.

Because sex becomes painful as a result, the women and their partners avoid it. This can destroy intimacy, have an adverse effect on emotional and physical health, and even ruin relationships, James A. Simon, MD, clinical professor of obstetrics and gynecology at the George Washington University School of Medicine in Washington, DC, and past president of NAMS, told Medscape Medical News.

Nobody in the United States wants to talk about “old ladies’ vaginas,” Dr. Simon said.

“This survey shows that less than half of menopausal women with vaginal dryness, pain with intercourse, or bleeding after sex are actually being treated…. We need to raise awareness and bring genital health into the conversation in the same way that erectile dysfunction was brought to the fore by Senator Dole, who made himself an example and a spokesperson for a very private thing,” he said. “We need a well-respected, visible, menopausal woman to bring this to the masses, because now we have survey data that say it’s not only prevalent, it’s not being adequately treated and it’s affecting relationships.”

Dr. Simon presented data from an international survey of 4167 cohabiting or married postmenopausal women 55 to 65 years of age with vaginal discomfort and 4174 of their aged-matched male partners from 9 countries: Canada, Denmark, Finland, France, Italy, Norway, Sweden, the United Kingdom, and the United States.

The survey was designed to assess the impact of vaginal atrophy and its treatment on emotional and physical relationships between postmenopausal women and their partners and to compare the insights, views, and attitudes in the United States with those in other countries.

In the online survey, participants were asked about the impact of vaginal atrophy and hormone therapy on intimacy, relationships, and self-esteem; the symptoms and impact of menopause, compared with their expectations; the willingness to discuss vaginal atrophy or erectile dysfunction with a partner or healthcare provider; and sources of information and advice.

Vaginal discomfort or atrophy symptoms include dryness, itching, burning, or soreness in the vagina, bleeding during intercourse, pain during intercourse, pain during urination, and pain in the vagina in connection with touching.

In their analysis of the data, Dr. Simon and colleagues focused on the 501 women and 509 men in the United States who were married.

Of all survey respondents, American women in were the least likely to use local vaginal estrogen treatment, “in spite of the fact that we have a high level of education, a high level of access to medical care, and coverage by most insurance plans for drugs in this category,” Dr. Simon said. “My conclusion is that women in this country fear estrogen more than elsewhere, so they won’t use it,” he said, adding that the fear is unjustified.

American women were the most likely (77%) to use lubricating gels and creams, but only 31% used hormone therapy, including local estrogen therapy, to relieve their symptoms.

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.