Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide. (June 2021)

• Record Type: Journal Article
• Authors: Hirschberg, Angelica Lindén; Bitzer, Johannes; Cano, Antonio; Ceausu, Iuliana; Chedraui, Peter; Durmusoglu, Fatih; Erkkola, Risto; Goulis, Dimitrios G.; Kiesel, Ludwig; Lopes, Patrice; Pines, Amos; van Trotsenburg, Mick; Lambrinoudaki, Irene; Rees, Margaret
• Is Part Of: Maturitas. Volume 148(2021)
• Page Start: 55
• Page End: 61
• Publication Date: 2021-06
• Subjects: Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2021.04.005
• Languages: English
• ISSNs: 0378-5122

Abstract

Highlights: Vulvovaginal atrophy is a chronic condition caused by estrogen deficiency. It affects around 50% of postmenopausal women, reducing their general and sexual quality of life as well as the quality of their personal relationships. Both topical estrogens and non-hormonal lubricants and moisturizers can be used to treat vulvovaginal atrophy. Non-hormonal preparations should be the first-line treatment for vulvovaginal atrophy in women taking adjuvant endocrine therapies for cancers considered to be hormone dependent. Abstract: Introduction: Vulvovaginal atrophy (VVA) is a chronic condition caused by estrogen deficiency. It affects around 50% of postmenopausal women, reducing their general and sexual quality of life as well as the quality of their personal relationships. Aim: The aim of this clinical guide is to set out an individualized approach to the management of VVA with topical estrogens and non-hormonal preparations. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: An individualized approach is required for the management of VVA. Topical low-dose estrogens are effective and also alleviate urinary incontinence and prevent recurrent urinary tract infections. Women should not be denied long-term use of topical estrogens as long as they feel that this treatment is of benefit to them, because the safety data are reassuring. Non-hormonal preparations (lubricants and moisturizers) should be the first-line treatment for VVA in women taking adjuvant endocrine therapies for cancers considered to be hormone-dependent. They can be used over the long term.