Although nearly half of postmenopausal women reported having vulvovaginal symptoms (VVS), only a minority discussed their symptoms during a well-woman visit with a primary care provider or gynecologist, according to a secondary analysis of a 2015 survey of 1,513 postmenopausal women.
“Despite the availability of safe and effective treatments, the Genitourinary Syndrome of Menopause (GSM) commonly affects postmenopausal women and reduces quality of life, yet it is under-recognized and undertreated,” said co-investigator Amanda Clark, MD, MCR, NCMP, an affiliate investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon.
Other studies indicate that VVS affects 39% to 51% of women and that 44% to 67% have discussed their symptoms with a health care professional. In addition, “lower urinary tract symptoms affect 75% of women aged 40 or greater, yet less than a third report having sought treatment,” said Dr. Clark, who shared survey results at The North American Menopause Society (NAMS) Annual Meeting in Chicago in September.
The survey study was part of a larger intervention trial, to test whether or not an educational initiative for clinicians could improve detection and treatment of GSM. Within 1 to 2 weeks of a well woman visit, women aged 55 and older were invited by email to participate in an online survey about their care experience related to GSM at the visit.
Overall, 45% of respondents (680 of 1,513) reported having VVS. However, only 40% of these women reported discussing the symptoms at the well visit. Well visits for symptomatic women occurred both in primary care (76%) and in gynecology (24%). But when well visits occurred in gynecology, 71% of women reported a discussion about VVS, compared to 30% of women who had a well visit by primary care. Perhaps more disturbing, though, is that it was the patient who was more likely to initiate the discussion than the clinician: 59% versus 22%, respectively.
Dr. Clark is a legal consultant for Butler Snow LLC, representing Ethicon, for pelvic mesh litigation.