Innovations in the Treatment of Dyspareunia
David J. Portman, MD
Director Emeritus, Columbus Center for Women’s Health Research
Adjunct Instructor of Obstetrics and Gynecology
Ohio State University
The aging of the US population has led to a substantial increase in the number of postmenopausal women. Currently, there are an estimated 64 million women in the United States who are postmenopausal, and that number is estimated to reach 1.1 billion women world-wide by 2025.1 Diminishing hormonal levels associated with the menopausal transition began years earlier, and can result in vasomotor symptoms (VMS), vulvovaginal atrophy (VVA), urinary symptoms, and dyspareunia. At least two-thirds of menopausal women experience VMS, which are often considered the “cardinal symptoms of menopause.”2 VMS, which include hot flashes and night sweats, can have a significant effect on quality of life, and lead many women to seek treatment for their symptoms.3 VMS typically are self-limiting, last for 4 years, on average, before spontaneously resolving, and are readily associated with menopause by both women and their health care provider (HCP).3,4 However, in a number of women, VMS can last 10 years or longer. In contrast, the symptoms of VVA, which result from thinning and inflammation of the vaginal walls, are chronic and progressive. VVA can cause vaginal dry-ness, itching, and soreness, and often leads to pain with sex and sexual dysfunction. Although at least 32 million women experience symptoms of VVA and/or dyspareunia, because these symptoms often do not manifest in and around the time of the last menses, a majority of these women are unaware that their symptoms are the result of underlying vulvovaginal and hormonal changes stemming from menopause.1,5 The overwhelm-ing majority of US women—approximately 93%—fail to seek treatment for VVA or dyspareunia.1
Murray A. Freedman, MS, MD, FACOG, IF
Clinical Professor of Obstetrics
Medical College of Georgia
Sheryl A. Kingsberg, PhD
Professor of Reproductive Biology
Case Western Reserve University
School of Medicine
David J. Portman, MD
Director Emeritus, Columbus Center
for Women’s Health Research
Adjunct Instructor of Obstetrics
Ohio State University
Disclosure of Conflicts of Interest:
In accordance with the ACCME Standards for Commercial Support, The Omnia-Prova Education Collaborative (TOPEC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TOPEC resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.
Murray A. Freedman, MS, MD, FACOG, IF Consulting Fees: AMAG Pharmaceuticals; Commercial Interest Speakers Bureau: Valeant Pharmaceuticals; Contracted Research: Procter and Gamble
Sheryl A. Kingsberg, PhD Consulting Fees: AMAG Pharmaceuticals, Emotional Brain, Palatin, Valeant Pharmaceuticals; Commercial Interest Speakers Bureau: AMAG Pharmaceuticals, Palatin, Valeant Pharmaceuticals; Contracted
David J. Portman, MD Consulting Fees: AMAG Pharmaceuticals, Palatin, Valeant Pharmaceuticals; Commercial Interest Speakers Bureau: AMAG Pharmaceuticals, Palatin, Valeant Pharmaceuticals; Contracted Research: Endoceutics
Sean T. Barrett has nothing to disclose.
Carole Drexel, PhD, CHCP has nothing to disclose.
Amanda Hilferty has nothing to disclose.
Ashley Rosenthal has nothing to disclose.
Robert Schneider, MSW has nothing to disclose.
After participating in this educational activity, participants should be better able to:
- Define vulvovaginal atrophy (VVA), and genitourinary syndrome (GSM) and their impact on post-menopausal dyspareunia
- Identify the factors, both clinician-based and patient-based, that may inhibit diagnosis of dyspareunia
- Describe clinician counseling approaches to facilitate a discussion with patients about their symptoms
- Discuss the benefits and risks of innovative therapeutic interventions indicated for the management of menopause-related dyspareunia
ACCREDITATION AND CREDIT DESIGNATION STATEMENTS:
The Omnia-Prova Education Collaborative, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Omnia-Prova Education Collaborative, Inc. designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The posttest and evaluation of this activity may be taken online by visiting www.omniaeducation.com/dyspareunia. CME credit may also be claimed by faxing the posttest/evaluation to 215.358.0556. A copy of the posttest/evaluation may also be mailed to Omnia Education 500 Office Center Drive, Suite 300 Fort Washington, PA 19034.
Omnia Education has a core focus on women’s health and the ways in which diseases and conditions impact the female patient. That unique focus has transformed the CME learning environment for healthcare professionals nationwide. We impact thousands of clinicians annually, many of whom return each year for clinical updates and connectivity with regional peers.
This activity is supported by an independent educational grant from AMAG Pharmaceuticals Inc.
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of TOPEC and Omnia Education. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of Omnia Education you are subject to the terms and conditions of use, including copyright and licensing restriction, of that site.
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