The silent epidemic of urogenital atrophy.

Urogenital atrophy describes the multiple changes in urogenital tissue quality, commonly due to hypoestrogenism associated with the menopause and ageing. These changes can result in pain and bleeding, most notably in association with sexual intercourse. The impact of urogenital atrophy on sexual function is determined by several factors, including a reduction in blood flow to the vulva and vagina, and a decrease in vaginal secretions. Sexual intimacy remains an important aspect of relationships for older women and enquiry about symptoms of urogenital atrophy should be routinely included in all consultations about menopause and in women aged ≥45 years attending for cervical screening. This would help to remove a major barrier, restricting access to diagnosis and treatment for affected women, who find the subject difficult to broach. Other hurdles to accessing treatment include limited research, the cost of treatment, and patients’ fear of hormonal treatment options.1 There are several key research surveys that demonstrate valuable information that could aid in advancing current clinical practice. These include the European REVIVE Survey2 and VIVA-LATAM.3 The REVIVE survey was conducted in Germany, Spain, Italy, and the UK (3768 postmenopausal women aged 45–75 years participated), while the VIVA-LATAM survey was conducted in Latin American countries including Argentina, Brazil, …