In the United States, there are approximately 64 million women who are postmenopausal. Of these women, it is estimated that 50%—or more than 32 million— have symptoms of vulvovaginal atrophy (VVA) and/or dyspareunia (painful sexual intercourse). These two conditions, along with several others, are components of the Genitourinary Syndrome of Menopause (GSM). GSM is a term introduced in 2014 by the North American Meno-pause Society (NAMS) and International Society for the Study of Women’s Sexual Health (ISSWSH) to describe the constellation of signs and symptoms associated with the decreased levels of estrogen and other sex steroids associated with menopause.
Many women are knowledgeable of the vasomotor symptoms (VMS) that often occur with menopause and seek treatment for these. However, many are less likely to recognize that VVA symptoms such as vaginal dry-ness and painful intercourse are treatable conditions that occur as a result of the hormonal changes of menopause. Additionally, these women may not be aware that, unlike vasomotor symptoms that spontaneously resolve, VVA is a chronic condition that worsens over time in the absence of treatment. Consequently, VVA often interferes with a woman’s sexual functioning, her overall quality of life, and can be the source of partnership issues. Historically, the standard treatment for VVA has been estrogen therapy, administered systemically (oral or patch) or topically (vaginal cream, tablet, ring). Two innovative, non-estrogen therapies – ospemifene and prasterone -- have been approved for the treatment of dyspareunia associated with VVA.
This CME-designated journal supplement is comprised of three articles that will provide information and strategies regarding best practices as to patient counsel-ing, diagnosis, and treatment of VVA, and its associated dyspareunia. The goal is to provide women’s health clinicians the knowledge and tools they need to optimize the care they provide to their menopausal patients
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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