J Clin Outcomes Manage
Evaluation and treatment of postmenopausal dyspareunia
Stockdale CK, Boardman LA
Abstract: Objective: To provide an overview of the diagnosis and treatment of women with postmenopausal dyspareunia. Methods: A literature review was conducted to identify current strategies for the diagnosis and treatment of postmenopausal dyspareunia. Results: Postmenopausal dyspareunia is under reported and underdiagnosed. Although it may be difficult for providers and patients to address, dyspareunia significantly impacts affected women and their partners. While there are many causes of postmenopausal dyspareunia, the initial evaluation should be directed toward consideration of vaginal atrophy due to lack of estrogen on urogenital tissue, especially among women reporting concomitant vaginal dryness. Beyond the use of local estrogen therapy for atrophic vaginitis, treatment is limited and often based on anecdotal evidence. Conclusion: Painful intercourse can arise in a number of settings, and it is important to evaluate post-menopausal women with dyspareunia rather than empirically treat for a presumptive diagnosis of vaginal atrophy. Treatment must be individualized and may require more than 1 modality.
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