19 Oct : October is month of Menopause Awareness and world menopause day is 18th October. This was initiated by the International Menopause Society (IMS) , in collaboration with the World Health Organization, as an opportunity to alert the world to the importance of the menopause and the impact that it has on the lives of so many women all around the world.
Theme this year is “Vaginitis – silent suffering for aging women”
New Recommendations have been launched by IMS to mark the menopause day this year, for the management of postmenopausal vaginal atrophy, a distressing condition that will affect up to half of women after menopause. This new guidance is essential as, according to new research, one in two women with vaginal atrophy (VA) will live with their condition unnecessarily despite effective treatments being available. This is largely due to poor awareness and understanding of the condition among women, and because VA is a “taboo” subject – even between a doctor and patient. Our patients may be reluctant to discuss issues related to genital health .In addition, women with VA may have cultural or religious reasons for not talking to their doctor about their symptoms, and women in general may be understandably reluctant to discuss such private matters, particularly with a male doctor. Most women express relief and respond positively when a doctor initiates the conversation about this topic.
VA is characterised by symptoms including vaginal dryness, itching, increased tendency of infection and pain during sex. It occurs when the vaginal walls become thin, fragile and inflamed due to a reduction of oestrogen in the body. While VA has an obvious impact on sexual intimacy, it also has negative consequences for a woman’s personal relationships, self-esteem and overall quality of life. If left untreated, VA can lead to serious long-term urogenital problems, including incontinence. However, despite these negative implications, just one in four women will actually speak to her doctor about VA.
The Recommendations note that many women may not report VA symptoms to their doctor because of concerns about taking hormone replacement therapy (HRT). Some of this reluctance is due to the adverse publicity for HRT over recent years, but, regardless of whether these concerns are justified, local oestrogen therapy for VA, which delivers a low dose of hormone directly to the vagina, is not associated with the possible risks of systemic (oral) HRT.
The new trend is low dose for the shortest time. That might be sufficient for systemic issues, but very often we are seeing that the vaginal tissue, the veins, arteries, nerves and tissues need local HT to improve. So the systemic [therapy] might be controlling one aspect,and we have to add on local estrogenic creams or tablet or rings, and if vasomotor symptoms are no more there then use only local hormones. Doctors need to ensure patients fully understand this, so that they can benefit from VA treatment.
