Impact Of Vulvovaginal Atrophy Of Menopause In Spanish Women: Prevalence And Symptoms According To The EVES Study

Santiago Palacios; Silvia P González; Micaela Fernández-Abellán; Montserrat Manubens; Pascual García-Alfaro; EVES Study Spanish investigators

doi:10.1016/j.esxm.2019.01.005

Impact Of Vulvovaginal Atrophy Of Menopause In Spanish Women: Prevalence And Symptoms According To The EVES Study

Sex Med. 2019 Jun;7(2):207-216. doi: 10.1016/j.esxm.2019.01.005. Epub 2019 Mar 16.

Authors

Santiago Palacios¹, Silvia P González², Micaela Fernández-Abellán³, Montserrat Manubens⁴, Pascual García-Alfaro⁵; EVES Study Spanish investigators

Affiliations

¹ Palacios Institute of Women's Health, Madrid, Spain. Electronic address: spalacios@institutopalacios.com.
² Policlínico HM Gabinete Velázquez, Madrid, Spain.
³ Instituto Materno Infantil Alhambra, Málaga, Spain.
⁴ Profs. S. Dexeus & F. Carmona Women's Health Institute, Barcelona, Spain.
⁵ Hospital Universitario Dexeus, Barcelona, Spain.

Abstract

Introduction: The prevalence of menopausal women with confirmed vulvovaginal atrophy (VVA) oscillates between 67-98%.

Aim: To assess the prevalence of postmenopausal women with VVA confirmed by gynecologic clinical assessment among all women attending menopause centers in Spain, as well as to describe the impact of VVA on quality of life and sexual functioning.

Methods: Women aged 45-75 years old with the last menstrual period >12 months before were included in a cross-sectional study.

Main outcome measures: Women with ≥1 VVA symptoms filled out a number of questionnaires, including EuroQoL, Day-to-Day Impact of Vaginal Aging, Female Sexual Function Index, and Female Sexual Distress Scale-revised. A gynecologic examination was performed to confirm diagnosis.

Results: 1,177 evaluable patients were included. VVA was confirmed in 87.3% of the patients. Almost 80% of women who acknowledged being sexually active (n = 717) presented pain during intercourse. As compared with patients without confirmed VVA (n = 66), patients with confirmed VVA (n = 1,028) were significantly older (P < .0001), had lower rates of sexual activity (P < .05), and used more VVA treatments (P < .05). Severe vaginal atrophy and severe vulvar atrophy were more prevalent in VVA-confirmed women (P < .0001, in both cases). No differences regarding the confirmation of VVA were observed for EuroQoL and Day-to-Day Impact of Vaginal Aging quality-of-life questionnaires. Sexual function measured through the Female Sexual Function Index score was significantly reduced in sexually-active patients with confirmed VVA (P < .05).

Conclusion: VVA signs and symptoms are highly prevalent in Spanish postmenopausal women. Confirmation of VVA diagnosis was associated with impaired sexual function. The early recognition of VVA symptoms should be actively promoted in medical practice, instead of waiting until signs appear to exclude other reasons for VVA and to manage treatment effectively. Palacios S, González SP, Fernández-Abellán M, et al. Impact of Vulvovaginal Atrophy of Menopause in Spanish Women: Prevalence and Symptoms According to the EVES Study. Sex Med 2019;7:207-216.

Keywords: DIVA; EQ5D3L; Gynecologic Exam; Menopause; Prevalence; Vulvovaginal Atrophy.