ARHP is sponsoring Vaginal Atrophy: The Wake-Up Call, an education program for health care providers. The goal of this program is to expand providers’ knowledge about symptoms common to vaginal atrophy, associated co-morbidities of decreased estrogen levels, and effective methods for screening, prevention, and treatment.  In addition, the program will improve providers’ competence to identify women at risk for or already suffering from debilitating vaginal atrophy; conduct appropriate screening, counseling, and risk assessment activities; gain confidence and efficacy to discus associated symptoms with patients; and implement customized prevention and treatment strategies, including hormone therapy when appropriate.  Finally, the program will enhance provider performance in practice leading to better health outcomes among patients living with vaginal atrophy.

For more information about the program, please contact Delysha D’Mellow Henry at dhenry@arhp.org or (202) 466-3825.

Background

Vaginal atrophy affects more than thirty percent of females throughout their lifetime.¹ Once classified as predominantly a menopausal issue, vaginal atrophy is now more frequently diagnosed in women that are breastfeeding or who have arthritis.^{2-3, 4}   Estrogen is the likely culprit. As estrogen depletes in the body, it triggers the onset of persistent conditions, such as vaginal dryness, night sweats, decreased libido, and increased risk of osteoporosis.^1-5 Women’s primary care providers (PCPs) - including family medicine providers, internists, and obstetricians/gynecologists - are encountering patients at risk for or already experiencing these disruptive and potentially disabling symptoms. While there are effective ways to prevent and treat these common conditions, PCPs fail to address these issues with their all female patients—putting millions of women at risk for a myriad of negative health outcomes.

As many as 30 million women are suffering from vulvovaginal atrophy, which can dramatically reduce their quality of life. The Mayo Clinic⁴ identifies various symptoms of vaginal atrophy, all of which have been reported to negatively impact quality of life among women of all ages experience symptoms.

Although the painful symptoms are treatable (and preventable), most women who develop vulvovaginal atrophy suffer in silence—often because either they or their health care providers are uncomfortable talking about vaginal health or hold preconceived notions about effective therapies.^6,7 Whether conscious or subconscious, these beliefs can interfere with the delivery of effective, high-quality health care.⁹ Since most women rely on their providers for information about their overall health, it is essential that clinicians are able to discuss and offer prevention and treatment options for vulvovaginal atrophy in an open, unbiased manner.

Program Design and Educational Activities

• An accredited Power point slide set with talking points
• 1 live visiting faculty session at Reproductive Health 2011 and 1 virtual conference (archived)
• Integration of content into the Curricula Organizer for Reproductive Health Education (CORE), ARHP’s on-line, open-access collection of peer-reviewed, evidence-based teaching materials

Curriculum Learning Objectives

At the conclusion of the medical education sessions, participants will be able to:

• Expand providers’ knowledge about symptoms common to vaginal atrophy, associated co-morbidities of decreased estrogen levels, and effective methods for screening, prevention, and treatment. 
• Improve providers’ competence to identify women at risk for or already suffering from debilitating vaginal atrophy; conduct appropriate screening, counseling, and risk assessment activities; gain confidence and efficacy to discus associated symptoms with patients; and implement customized prevention and treatment strategies, including hormone therapy when appropriate. 
• Enhance provider performance in practice leading to better health outcomes among patients living with vaginal atrophy.

Intended Audience and Accreditation

This program includes educational offerings for women’s health and primary care providers and educators (physicians, nurse practitioners, physician assistants, nurse midwives, and educators in ob/gyn, family medicine, internal medicine, and related fields). 

The live session and virtual conference associated with this program will be accredited for continuing medical education and nursing contact hours.

Funding

This project is funded through educational grants from NovoNordisk and Endo Pharmaceuticals.

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1. Shen W, Stearns V. Treatment strategies for hot flushes. Expert Opin Pharmacother. 2009 May; 10(7):1133-44.
2. Thurston RC, Bromberger JT, Joffee H, et al. Beyond frequency: Who is most bothered by vasomotor symptoms? Menopause. 2008 Sep-Oct; 15(5):841-7.
3. Politi MC, Schleinitz MD, Col NF. Revisiting the duration of vasomotor symptoms of menopause: A meta-analysis. J Gen Intern Med. 2008 Sep; 23(9):1507-13
4. The Mayo Clinic. Vaginal atrophy. http://www.mayoclinic.com/health/vaginal-atrophy/DS00770/DSECTION=symptoms. Accessed Dec 2011.
5. Avis NE, Brockwell S, Randolph JF, et al. Longitudinal changes in sexual functioning as women transition through menopause: Results from the Study of Women’s Health Across the Nation. Menopause. 2009 May-Jun; 16(3):442-52.
6. Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med. 2009 Aug; 6(8):2133-42.
7. Staines R. Post-menopausal women reluctant to seek help for vaginal dryness. Nursing Times. 2009 May 20. www.nursingtimes.net.
8. Nappi RE, Lachowsky M. Menopause and sexuality: Prevalence of symptoms and impact on quality of life. Maturitas. 2009 Jun 20; 63(2):138-141.
9. Thompson MM. Women’s attitudes, perceptions, and knowledge about the vagina. SRM. 2006 Oct; 4(2):74-79.