Lack of appropriate treatment for a common, taboo condition known as vaginal atrophy means that post-menopausal women in Britain are experiencing less sex, and less satisfying sex compared to their European and North American counterparts, a new study published in the journal Menopause International reveals.
The first-of-its-kind study, called the CLarifying vaginal atrophy's impact On SEx and Relationships (CLOSER) study, showed that British post-menopausal women with vaginal atrophy are more likely to experience less sex1, and less satisfying sex, compared to other women in Europe and North America (67% and 61% vs 58% and 49% overall, respectively)1. Fear of painful sex was one of the main reasons women avoided intimacy (63%)1, with almost one third of women (30%) and male partners (29%) saying that vaginal discomfort had caused a "big problem" for their sex lives1.
Despite over one and a half million women across the UK potentially experiencing this problem2,4, British women in CLOSER were 50% less likely (21% versus 41% overall) to receive local oestrogen treatment, compared to women from other countries1.
"Given the obvious impact of vaginal atrophy on women in the UK, and their partners, it is very sad to learn that we are lagging behind other Western countries in terms of ensuring appropriate access to treatment," commented Dr Heather Currie, co-author of the study and Associate Specialist Gynaecologist at the Dumfries and Galloway Royal Infirmary, founder of menopausematters.co.uk and Honorary Secretary of the British Menopause Society. "It is our hope that the CLOSER study will encourage our fellow medical professionals, and women themselves, to routinely raise the topic of post-menopausal vaginal health, thereby facilitating appropriate diagnosis and treatment."
Vaginal atrophy is a chronic condition caused by a drop in oestrogen levels, with symptoms including vaginal dryness, itching and painful intercourse5. The condition can have a significant emotional impact, as well as on quality of life, and can lead to serious long-term urogenital problems if left untreated (e.g. incontinence)6.
Local oestrogen, the preferred treatment for vaginal atrophy according to The British Menopause Society7, is applied directly to the vagina while, in systemic hormone therapy, the hormones travel around the entire body7. As vaginal atrophy is a chronic condition, treatment needs to be continued to maintain the benefits7.
"More than two-thirds (68%) of British women in CLOSER used lubricants and moisturisers to treat their vaginal symptoms, but these are not as effective as oestrogen therapy as they do not treat the underlying cause," explained Dr Nick Panay, co-author and Consultant Gynaecologist, Queen Charlotte's & Chelsea and Chelsea & Westminster Hospitals, London, and Immediate Past Chair of the British Menopause Society. "Local oestrogen offers women a well-tolerated and effective solution to vaginal atrophy which, as the CLOSER study illustrates, can significantly disrupt many relationships."
British women who had tried local oestrogen treatment for vaginal atrophy reported beneficial effects such as less painful sex (58%)8, more satisfying sex for their partner (42%)8 and themselves (40%)8, feeling closer and less isolated from their partner (33%)8, having sex more often (27%)8, and saying that they now look forward to having sex (26%)8.