MD (Gold Medalist)
Vaginal Atrophy: What the CLOSER Survey Reveals
Vaginal atrophy (VA) has a great effect on women and their male partners, according to survey results recently published in the Journal of Sexual Medicine.
It’s possible that these results may prompt more communication about VA between couples and their healthcare providers.
Vaginal atrophy refers to changes in the vagina caused by menopause. When estrogen levels drop, the vagina may lose some elasticity, leading to dryness, discomfort, and pain. Some studies estimate that over half of women experience some degree of vaginal atrophy. However, VA is not something many women freely discuss.
To learn more about how VA affects women and their male partners, a research team from Italy and the United States conducted a survey, which was administered online to 4,100 women and 4,100 men from nine countries: the United Kingdom, Finland, Norway, Sweden, Denmark, Italy, France, Canada, and the U.S.
The assessment was called the CLOSER (CLarifying Vaginal Atrophy’s Impact On SEx and Relationships) Survey.
The women were between 55 and 65 years old and had stopped menstruating at least 12 months prior to the survey. They also had symptoms of VA.
The men were in relationships with postmenopausal women aged 55 to 65 who had vaginal discomfort. They were not partnered with the female participants.
For both men and women, VA/vaginal discomfort were described as, “dryness, itching, burning, or soreness in the vagina, bleeding during intercourse, pain during urination, or pain in the vagina in connection with touching and/or intercourse.”
The survey included questions about vaginal discomfort, its symptoms, and its effects on intimacy, relationships, and self-esteem. Participants were also asked about erectile dysfunction (ED) and VA treatments, such as local estrogen therapy (LET).
Most of the women (72%) said that they told their partners when they first felt vaginal discomfort. The other 28% did not do so, explaining that they were embarrassed or thought their symptoms were a normal part of aging. Thirty-six percent said they would try self-treatment before telling their partner about their symptoms.
The authors noted that the men were more likely to discuss VA than the women were, although they were not always aware that sex was uncomfortable for their partner.
Half the women said they were “upset their body does not work as it used to.” Others reported that they felt old and sexually unattractive. Some lost confidence as a sexual partner and others felt that the symptoms would never go away.
Many sexual behaviors changed as a result of VA. Over half the participants said they had less sex and almost a quarter stopped having sex altogether. Sixty-two percent of the women and 76% of the men said they avoided intimacy.
Fifty-eight percent of the women used vaginal moisturizers or lubricants to alleviate their symptoms. Only 15% of the men knew that their partner was using this type of treatment.
Local estrogen therapy appeared to improve sex lives, relationships, and quality of life. Over half the men and women said that sex was less painful and almost half the women said sex was more satisfying.
The researchers stressed the importance of communication about VA between couples themselves and with their healthcare providers.
They also explained the role of healthcare providers in that discussion. “Because women may not be willing to openly discuss the vaginal discomfort they are experiencing, it is crucial for [healthcare providers] to be proactive in helping women address the issue of VA,” they wrote.
The Journal of Sexual Medicine
Nappi, Rossella E., MD, PhD, et al.
“The CLOSER (CLarifying Vaginal Atrophy's Impact On SEx and Relationships) Survey: Implications of Vaginal Discomfort in Postmenopausal Women and in Male Partners”
(Full-text. First published online: June 27, 2013)
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