Uncover how sexual pain impacts sexual intimacy1,21
Vulvar and vaginal atrophy (VVA), also known as genitourinary syndrome of menopause (GSM), causes sexual pain and a decrease in arousal, orgasm, and desire.5,21
Consequences of vaginal pain and discomfort* on relationships†,1
* Vaginal discomfort was defined in both the female and male questionnaires 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.”
† Data from a worldwide survey (N=8,200 respondents) conducted to better understand the emotional and physical impact of VA between postmenopausal women and their male partners.
Adapted from Nappi et al. 2013.1
High level of intimacy avoidance for both men and women1
- Sexually inactive couples are unhappier about their relationships and have more negative interactions than couples who remain sexually engaged22
One-fourth of postmenopausal women with vaginal atrophy symptoms believe intimacy with their partner is no longer possible.1
1. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy’s Impact On Sex and Relationships) survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med. 2013;10(9):2232-2241. 2. Berger L, El-Alfy M, Martel C, Labrie F. Effects of dehydroepiandrosterone, Premarin and Acolbifene on histomorphology and sex steroid receptors in the rat vagina. J Steroid Biochem Mol Biol. 2005;96(2):201-215. 3. Goldstein I, Dicks B, Kim NN, Hartzell R. Multidisciplinary overview of vaginal atrophy and associated genitourinary symptoms in postmenopausal women. Sex Med. 2013;1(2):44-53. 4. Goldstein I. Female sexual function and dysfunction. In: Raz S, Rodriguez L, eds. Female Urology. 3rd ed. Philaelphia, PA: Saundes Elsevier;2008:505-524. 5. Goldstein I. Recognizing and treating urogenital atrophy in postmenopausal women. J Womens Health (Larchmt). 2010;19(3):425-432. 6. Jannini EA, d’Amanti G, Lenzi A. Histology and immunohistochemical studies of female genital tissue. In: Goldstein I, Meston CM, Davis S, Traish A, eds. Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment. Boca Raton, FL: CRC Press;2005:125-133. 7. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010;85(1):87-94. 8. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013;20(9):888-902. 9. Labrie F, Martel C, Pelletier G. Is vulvovaginal atrophy due to a lack of both estrogens and androgens? Menopause. 2017;24(4):452-461. 10. Labrie F. DHEA after menopause: sole source of sex steroids and potential sex steroid deficiency treatment. Menopause Manag. 2010;19:14-24. 11. Castelo-Branco C, Cancelo MJ, Villero J, Nohales F, Juliá MD. Management of post-menopausal vaginal atrophy and atrophic vaginitis. Maturitas. 2005;52(Suppl 1):S46-S52. 12. Wysocki S, Kingsberg S, Krychman M. Management of vaginal atrophy: implications from the REVIVE Survey. Clin Med Insights Reprod Health. 2014;8:23-30. 13. Semmelink HJ, de Wilde PC, van Houwelingen JC, Vooijs GP. Histomorphometric study of the lower urogenital tract in pre- and post-menopausal women. Cytometry. 1990;11(6):700-707. 14. Sturdee DW, Panay N; International Menopause Society Writing Group. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509-522. 15. American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Gynecology. ACOG Practice Bulletin No. 119: Female sexual dysfunction. Obstet Gynecol. 2011;117(4):996-1007. Reaffirmed 2015. 16. Labrie F, Bélanger A, Pelletier G, Martel C, Archer DF, Utian WH. Science of intracrinology in postmenopausal women. Menopause. 2017 Jan 16. doi: 10.1097/GME.0000000000000808. 17. Archer DF, Labrie F, Bouchard C, et al; VVA Prasterone Group. Treatment of pain at sexual activity (dyspareunia) with intravaginal dehydroepiandrosterone (prasterone). Menopause. 2015;22(9):950-963. 18. Labrie F, Archer DF, Koltun W, et al; VVA Prasterone Research Group. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016;23(3):243-256. 19. Berger L, El-Alfy M, Labrie F. Effects of intravaginal dehydroepiandrosterone on vaginal histomorphology, sex steroid receptor expression and cell proliferation in the rat. J Steroid Biochem Mol Biol. 2008;109(1-2):67-80. 20. Labrie F, Luu-The V, Labrie C, Simard J. DHEA and its transformation into androgens and estrogens in peripheral target tissues: intracrinology. Front Neuroendocrinol. 2001;22(3):185-212. 21. Portman DJ, Gass ML; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Maturitas. 2014;79(3):349-354. 22. Galinsky AM, Waite LJ. Sexual activity and psychological health as mediators of the relationship between physical health and marital quality. J Gerontol B Psychol Sci Soc Sci. 2014;69(3):482-492.