Percepción y actitudes de los ginecólogos españoles frente al síndrome genitourinario de la menopausia. Estudio VUVAGINE / Perception and attitudes of Spanish gynecologits against the genitourinary syndrome during the menopause. VUVAGINE Study

Objetivo: describir y analizar los resultados de un cuestionario diseñado para evaluar diferencias de percepción y actitudes entre los ginecólogos españoles (varones y mujeres) en relación con el abordaje del síndrome genitourinario de la menopausia (SGUM). Material y métodos: estudio transversal mediante una encuesta, cumplimentada por ginecólogos españoles. Se analizan las características basales del ginecólogo, anamnesis proactiva en el SGUM, orientación terapéutica y preventiva y autoprescripción/a la pareja de los ginecólogos varones. Resultados: se analizaron 213 cuestionarios. Son destacables las diferencias entre lo que el ginecólogo preferiría teóricamente prescribir (terapia hormonal asociada a lubricantes), lo que prescribe y lo que estima mejor aceptado por las pacientes (solo hidratantes). Eliminando la influencia de las variables de confusión, no existen diferencias significativas entre los resultados en ginecólogos varones y mujeres, de forma que la variable que condiciona las diferencias es el tipo de actividad del profesional. En la praxis privada se pregunta significativamente más sobre sintomatología vulvovaginal, urinaria y disfunciones sexuales; se dispone de más tiempo para incidir en ella, y mayor uso de probióticos. La terapia autoprescrita mayoritaria es la hormonal, asociada o no a hidratantes (73,1 vs. 63,6% en la pública y privada, respectivamente). Conclusión: la mayoría de los ginecólogos encuestados abordan en su práctica clínica el diagnóstico y tratamiento del SGUM, si bien se identifican diferencias entre los ginecólogos que desarrollan su actividad en el ámbito público frente al privado. Del mismo modo, existe diferencia entre prescripción y autoprescripción, si bien la terapia hormonal asociada o no a hidratantes resulta ser la mayoritaria en todos los subgrupos (AU)

Objective: To describe and analyse the results of a questionnaire designed to evaluate the existence of differences between perceptions and attitudes of Spanish gynaecologists (male and female) regarding the approach of Genitourinary Syndrome of Menopause (GSM). Material and methods: A cross-sectional study was made by means of a survey form completed by Spanish gynaecologists. The gynaecologist’s baseline characteristics, data on proactive history taking about GSM symptom, prevention and therapeutic approach and self-prescription/recommendations to the gynecologist’s couple were analysed. Results: Two hundred-thirteen valid questionnaires were analysed. In that analysis, the significant differences between what the gynaecologists theoretically would prescribe (hormonal therapy associated to moisturizers), what they in the daily practice prescribe and what they think the patients would accept (only lubricants and/or moisturizers). There are no significant differences between male and female gynaecologists in each category or in each age group, excluding the influence of confusion variables. This means that the differences are due to the professional activity area. Thus in private practice is significantly often to be asked about vulvovaginal and urinary symptoms and sexual disfunction, there is more time to inquire about it, the price is less considered when prescribing and there is a better knowledge and greater use of probiotics. The majority self-prescripted therapy was the hormonal therapy associated or not to moisturizers/lubricants (73.1 vs. 63.6% of self-medication in public and private practice respectively). Conclusion: The majority of the asked gynaecologists deal with diagnosis and treatment of GSM in their daily practice, although there are significant differences between the gynaecologists that work mainly at the public practice and the ones that work at the private practice. In the same way, there is a slight difference in prescription and self-prescription, even though hormonal therapy associated or not to moisturizers are the most prevalent products used in all groups (AU)

Frequency of FRAX risk factors in osteopenic postmenopausal women with and without history of fragility fracture.

OBJECTIVE: Fractures associated with bone fragility represent a major public health concern. Although the risk of bone fracture is higher among patients with osteoporosis, the number of fractures is usually higher among patients with osteopenia due to its higher prevalence. METHODS: This is an observational case series study that compares the frequencies of nonskeletal risk factors for osteoporotic fractures in osteopenic postmenopausal women with previous clinical fragility fractures (FFs) and osteopenic postmenopausal women without previous FF. Risk factors included in the FRAX algorithm and other selected risk factors, including asymptomatic vertebral fractures, were evaluated. RESULTS: A total of 735 (50.3% with prior FF and 49.7% without prior FF) postmenopausal women were evaluated (median age, 60 y; mean bone mineral density [BMD] femoral neck T score of -1.67). The frequency of the following risk factors was significantly higher among women with FF-FRAX algorithm: age, use of corticosteroids, and BMD femoral neck T score; other factors: Hispanic ethnicity, falls during the last year, and BMD lumbar T score. In addition, the frequency of previously undetected asymptomatic vertebral fractures was four times higher among women with a history of FF. CONCLUSIONS: The results of the present study support the need to assess the presence of asymptomatic vertebral fractures and BMD T scores in osteopenic postmenopausal women. The risk evaluation of this subpopulation can be accomplished by using some of the risk factors included in the FRAX algorithm combined with other conventional risk factors.