Impact Of Vulvovaginal Atrophy Of Menopause In Spanish Women: Prevalence And Symptoms According To The EVES Study.

INTRODUCTION: The prevalence of menopausal women with confirmed vulvovaginal atrophy (VVA) oscillates between 67-98%. AIM: To assess the prevalence of postmenopausal women with VVA confirmed by gynecologic clinical assessment among all women attending menopause centers in Spain, as well as to describe the impact of VVA on quality of life and sexual functioning. METHODS: Women aged 45-75 years old with the last menstrual period >12 months before were included in a cross-sectional study. MAIN OUTCOME MEASURES: Women with ≥1 VVA symptoms filled out a number of questionnaires, including EuroQoL, Day-to-Day Impact of Vaginal Aging, Female Sexual Function Index, and Female Sexual Distress Scale-revised. A gynecologic examination was performed to confirm diagnosis. RESULTS: 1,177 evaluable patients were included. VVA was confirmed in 87.3% of the patients. Almost 80% of women who acknowledged being sexually active (n = 717) presented pain during intercourse. As compared with patients without confirmed VVA (n = 66), patients with confirmed VVA (n = 1,028) were significantly older (P < .0001), had lower rates of sexual activity (P < .05), and used more VVA treatments (P < .05). Severe vaginal atrophy and severe vulvar atrophy were more prevalent in VVA-confirmed women (P < .0001, in both cases). No differences regarding the confirmation of VVA were observed for EuroQoL and Day-to-Day Impact of Vaginal Aging quality-of-life questionnaires. Sexual function measured through the Female Sexual Function Index score was significantly reduced in sexually-active patients with confirmed VVA (P < .05). CONCLUSION: VVA signs and symptoms are highly prevalent in Spanish postmenopausal women. Confirmation of VVA diagnosis was associated with impaired sexual function. The early recognition of VVA symptoms should be actively promoted in medical practice, instead of waiting until signs appear to exclude other reasons for VVA and to manage treatment effectively. Palacios S, González SP, Fernández-Abellán M, et al. Impact of Vulvovaginal Atrophy of Menopause in Spanish Women: Prevalence and Symptoms According to the EVES Study. Sex Med 2019;7:207-216.

[Health-related quality of life in the Spanish women through and beyond menopause. Development and validation of the Cervantes Scale]. / Calidad de vida relacionada con la salud en la mujer española durante la perimenopausia y posmenopausia. Desarrollo y validación de la Escala Cervantes.

BACKGROUND AND OBJECTIVE: There are numerous health-related quality of life questionnaires but only a few are specific for the menopause. The objective of this study was to develop and validate a specific scale, the Cervantes Scale, for menopause in Spanish women. SUBJECTS AND METHOD: This cross-sectional study included a pilot phase, construction of the questionnaire, validation, and test-retest reliability. A population-based sample of 2,274 women ponderated by age groups and education levels was used in the validation phase. Internal consistency was assessed with the Cronbach's alpha analysis. RESULTS: The final questionnaire included 31 items ("menopause and health" with 15 items made up of vasomotor symptoms, health and aging, "sexuality" with 4 items, "couple relationship" with 3 items and "psychical domain" with 9 items). The Cronbach's (coefficient of the scale was 0.9092. The correlation coefficient of the test-retest was r=0.847 (p<.001). The Cervantes Scale is short, easy to administer (about 7 minutes), has a minimal score of 0 and a maximal score of 155 (from better to worse quality of life) and scores can be compared to reference values in younger women and women of the same age. CONCLUSIONS: The Cervantes Scale is included in the new generation of instruments of health-related quality of life specific for the menopause and is intended to be used in Spanish women aged between 45 and 64 years.

Position of the Spanish Menopause Society regarding vaginal health care in postmenopausal women.

Vaginal health, defined as the vaginal state in which the physiological condition remains stable, being protected from the onset of symptoms and facilitating a satisfying sex life, is one of the most common and less valued concerns in postmenopausal women. Many of the conditions that affect the vagina are related to its trophism and susceptibility to infection by unusual germs, which are phenomena strongly influenced by estrogen impregnation and the microbiota composition, ultimately affecting sexuality and the quality of life. An expert panel of the Spanish Menopause Society met to establish criteria for diagnosing and treating the processes that affect overall vaginal health and to decide the optimal timing and methods based on the best evidence available.

Spanish Menopause Society position statement: use of tibolone in postmenopausal women.

Tibolone is a drug with complex tissue-specific action that exhibits a combination of estrogenic, progestogenic, and slight androgenic activity. Its variable profile explains its clinical effects, depending on the target tissue where it is metabolized, its metabolites' affinity for and potency in hormone receptors, and probable enzymatic activity modulation.In recent reviews and clinical trials, the effectiveness of tibolone in alleviating different hot flush menopause symptoms, mainly in mood and sexuality disorders, has been noted. In Spain, tibolone is the most prescribed hormonal treatment, and one of the most common complaints among postmenopausal women is change in sexual drive. For such reason, a panel of experts from the Spanish Menopause Society met to develop usage recommendations based on the best evidence available.

Understanding how personality factors may influence quality of life: development and validation of the Cervantes Personality Scale.

OBJECTIVE: To develop and validate a simple personality scale to be used as a complementary tool for menopause-specific quality-of-life instruments. DESIGN: A population-based random sample of 2,274 Spanish women stratified by age groups and education level was used in the validation phase. The initial 94-item questionnaire was reduced to 20 items by examining the frequency and variability with which women were responding to each of the items. The measurement properties were tested by conducting reliability (internal consistency and test-retest) and validation analyses (correlations, and factor analysis). RESULTS: The final 20-item scale consisted of three domains: introversion (seven items), emotional instability (seven items), and insincerity (control subscale, six items). Cronbach's alpha coefficients for the subscales of emotional instability, introversion, and insincerity were 0.7966, 0.7135, and 0.7042, respectively. The test-retest correlation was r = 0.763 for introversion, r = 0.720 for emotional instability, and r = 0.680 for insincerity (P < 0.001). The Cervantes Personality Scale is short and easy to administer. Scores range from 0 (the most extraverted personality) to 35 (the most introverted personality) for the introversion domain, from 0 (the most emotionally stable personality) to 35 (the most emotionally unstable personality) for the emotional instability domain, and from 0 (the most sincere response) to 30 (the most insincere response) for the insincerity domain. CONCLUSIONS: A novel self-report 20-item scale for assessing three stable personality traits (introversion, emotional instability, and insincerity) in peri- and postmenopausal women is presented. We provide preliminary evidence that the Cervantes Personality Scale is a useful psychometric tool for studying personality in women going through the menopausal transition.