[Skip to Content]
[Skip to Content Landing]
Views 3,078
Citations 0
Invited Commentary
March 19, 2018

Rethinking the Approach to Managing Postmenopausal Vulvovaginal Symptoms

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2San Francisco Veterans Affairs Health Care System, San Francisco, California
JAMA Intern Med. Published online March 19, 2018. doi:10.1001/jamainternmed.2018.0094

In this issue of JAMA Internal Medicine, Mitchell et al1 present the results of a randomized, double-blind, placebo-controlled, multisite trial of 2 existing, widely used treatments for postmenopausal vulvovaginal atrophy symptoms—a low-dose prescription vaginal estradiol tablet (Vagifem) and an over-the-counter nonhormonal vaginal moisturizing gel (Replens). Participants were postmenopausal women who rated the severity of their vulvovaginal symptoms including itching, pain, dryness, irritation, and pain with vaginal intercourse on a standardized scale. Consistent with US Food and Drug Administration guidance, the investigators examined change in severity of participants’ “most bothersome symptom” over 4 and 12 weeks as the primary outcome, along with a variety of secondary symptom-based outcomes and tissue-specific markers of vulvovaginal atrophy.

First Page Preview View Large
First page PDF preview
First page PDF preview
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×