Management of vaginal atrophy: a real mess. Results from the AGATA study

Objectives: To investigate the management of vaginal atrophy (VA) in a population-based study. Study design: A sub-study of a cross-sectional multicenter study on 913 postmenopausal women. Main outcome measures: Management of VA was investigated on the 274 women referring having received a previous diagnosis of VA. Results: Women had received, no therapy (9.8%), systemic hormones (9.2%), intra-vaginal estrogens (44.5%) or local non-hormonal (36.5%) therapy. There was heterogeneity of treatments. Local therapies were given in cycles, and used for a length of time ranging from 1 to 12 months. At the time of the investigation 59.5% of these women were not on treatment, either because following the physician's indication (31.1%) or because spontaneously withdrawing from treatment (68.9%). Reasons for withdrawing from therapy were insufficient symptom relief (46.6%), messiness (24.3%), difficulty in application (7.8%) and vaginal discharge (1.9%). At the time of investigation only 2.9% of treated women did not suffer from VA. Conclusions: This study underlines the presence of a great confusion about the therapy used for VA, along with patients' dissatisfaction with actual treatments. The emerging evidence is that in real world VA remains untreated