The silent epidemic: Postmenopausal vaginal atrophy

Postmenopausal hot flushes and night sweats will affect the quality of life of 25-75% of women and are well recognised and often treated by the medical profession. Atrophic symptoms affecting the vagina and lower urinary tract will also be experienced by a majority of women after the menopause causing itching, burning, and dyspareunia and sexual activity is often compromised. However only a minority will seek advice and fewer will receive helpful treatment. Some of this reluctance is due to the adverse publicity for hormone replacement therapy (HRT) in recent years, but regardless of whether these scares are justified, local treatment of vaginal atrophy is not associated with the possible risks of systemic HRT. Other reasons for the continued suffering in silence may be cultural and an understandable reluctance to discuss such matters, particularly with a male doctor, but the medical profession must take much of the blame for failing to enquire of all postmenopausal women about the possibility of vaginal atrophic symptoms