Vulvovaginal Atrophy Clinical Trial
Official title:
Retrospective Chart Review to Investigate an Association Between Vulvovaginal Atrophy and High Tone Pelvic Floor Dysfunction (HTPFD)
Dyspareunia, or painful intercourse, is one of the most commonly reported complaints in
postmenopausal women. One common cause of dyspareunia is vaginal atrophy (VVA), which occurs
in >50% of postmenopausal women. At the time of menopause, a lack of estrogen thins the
vaginal mucosa and lessons lubrication, making sex painful. Some women with vaginal atrophy
will also have high tone pelvic floor dysfunction (HTPFD) (also known as levator spasm).
Successful treatment of the sexual pain requires treatment of both vaginal atrophy and HTPFD.
How often vaginal atrophy and HTPFD coexist has not been studied. In fact, the prevalence of
HTPFD is unknown. This is most likely due to the fact that many clinicians are unaware of its
existence or how to diagnose or treat it. Also, sexual symptoms tend to be underreported due
to embarrassment or hesitation to seek care. HTPFD frequently coexists with other conditions
that cause pain like vaginal atrophy, endometriosis or interstitial cystitis. Treatment
includes treating both conditions. If only one is treated, then sexual pain is likely to
continue. There are several available treatments for HTPFD that have been studied including
physical therapy, botox and intravaginal diazepam.
This is an area where clinicians may be under treating a condition and limiting the
possibility of restoring normal sexual function to many women. Treating only vaginal atrophy
without appropriate evaluation and treatment of HTPFD leaves a cohort of women still
struggling with sexual pain. With a better understanding of the relationship between HTPFD
and vaginal atrophy, the investigators hope to bring awareness concerning the importance of
treating both in restoring normal sexual function.
This is a retrospective chart review that will be performed to identify all female patients
in the electronic medical records with a diagnosis of vulvovaginal atrophy (VVA).
The records of these patients with VVA will be examined for demographics, symptoms, answers
to standardized questionnaires ( e.g. Female Sexual Function Index - FSFI - that is routinely
assessed during clinical evaluation), work-up, diagnosis, and/or treatment of high tone
pelvic floor dysfunction (HTPFD). Symptoms of HTPFD include but are not limited to pelvic
pressure or pain, and dyspareunia. These data will then undergo statistical analysis.
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