Severe postmenopausal symptoms worsen quality of life : Menopause study

Severe urinary and sexual health problems may lead to poorer quality of life in postmenopausal women, suggests a new study.

The study, published in the journal Menopause, finds that women with severe vulvovaginal atrophy (VVA) symptoms including vaginal dryness, painful intercourse, and urinary incontinence, had a much worse quality of life compared with women with mild symptoms.

Rossella Nappi of the University of Pavia in Italy and colleagues conducted this subanalysis of the European Vulvovaginal Epidemiology Survey study to assess the correlation of VVA symptoms and severity, when confirmed by objective gynecologic examination, with the quality of life of postmenopausal women.

For the purpose, the research team examined survey data from 2,160 women, ages 45 to 75. Those women had at least one VVA symptom filled in a group of questionnaires, including EuroQol-EQ-5D-3L and Day-to-Day Impact of Vaginal Aging (DIVA). For confirming the VVA diagnosis, an objective gynecologic examination was also performed.

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Key Findings:

• Of a total of 2,160 evaluable women, 66.3%, 30.5%, and 11.2% suffered from severe vaginal, vulvar, and urinary symptoms, respectively.


• VVA was confirmed in more than 90% of the participants.


• For both EQ-5D-3L and DIVA, the overall scores and most of the dimensions/components were statistically significantly worse for women with severe VVA symptoms (vulvar and urinary) compared with women not affected by severe symptoms.


• Quality of life questionnaires showed worse scores in women where the diagnosis of VVA was confirmed by gynecologic examination.

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The results suggest that many women may be needlessly suffering from symptoms they either don't discuss with their doctor or don't know it's possible to treat, Dr Nappi told Reuters Health.

"It is important to give dignity to a set of symptoms that most people believe are trivial, not important, not relevant to be treated," said Nappi. "Some people believe they will go away with time and do not understand the chronic nature of conditions that are not life-threatening but may significantly impact intimacy, self-esteem and body image."

"This important effect on the quality of life of many women should be recognized as equivalent to those from other conditions and pathologies of which there is greater awareness," concluded the authors.