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1. Introduction
2. Rational for learning about menopause
3. Vulvovaginal atrophy
4. Etiology of vaginal atrophy
5. Physiology of premenopausal vagina
6. Estrogen receptors present in the urogenital area
7. Postmenopausal vagina
8. Proposed cascade of changes VVA
9. Clinical appearance (1)
10. Development of vulvovaginal atrophy
11. Clinical appearance (2)
12. Physiology of vulvar changes
13. Physiology of vaginal changes
14. Genital symptoms with vaginal atrophy
15. Physical examination of vulva
16. Physical examination of vagina
17. Clinical testing
18. Vaginal pH
19. Wet mount
20. Vaginal maturation index (VMI or MI)
21. Superficial and intermediate and atrophic cells
22. Urethral changes with atrophy
23. Typical urethral caruncle
24. Management of urethral caruncle/prolapse
25. Urogenital changes
26. Symptoms of urogenital atrophy: bladder
27. Differential diagnosis for symptoms of VVA
28. Lichen sclerosis of vulva
29. Lichen sclerosis example
30. Lichen planus
31. Lichen planus example
32. Estrogen levels are decreased postmenopausally
33. Impact of estrogen deficiency on sexual function
34. Low estrogen and prevalence of sexual problems
35. VVA vicious cycle
36. First line therapy
37. Non hormonal treatment options
38. Beware of sensitivity or allergies
39. Replens
40. Herbal remedies use
41. Soy rich diet and vaginal atrophy
42. Phytoestrogen genistein (54 mg/d)
43. Estrogen therapy and vagina
44. Vaginal biopsies
45. Systemic effects of vaginal estrogens
46. Serum E2 levels with 25 ug vaginal estradiol use
47. Plasma E2 and E1 levels after CE administration
48. Lower dose vaginal atrophy PK study
49. Endometrial effects
50. NAMS 2007 position statement
51. Estrogen products for vaginal atrophy
52. The different applicators
53. Fingertip applicator method
54. Issues with vaginal estrogen
55. Vaginal atrophy treatment duration
56. Vaginal atrophy in women with malignancy
57. Dyspareunia
58. Vaginal dilators
59. Example of vaginal dilators
60. Bladder and urinary symptoms
61. Future options in testing
62. Clinical scenario (1)
63. Clinical scenario (2)
64. Vulvovaginal atrophy conclusion
65. Concluding remarks
66. References (1)
67. References (2)
68. References (3)
69. References (4)

Topics Covered

• Vulvovaginal atrophy
• Physiology of premenopausal vagina
• Postmenopausal vagina
• Development of vulvovaginal atrophy
• Physiology of vulvar and vaginal changes
• Physical examination of vulva and vagina
• Vaginal maturation index (VMI or MI)
• Urethral changes with atrophy
• Urogenital changes
• Estrogen levels are decreased postmenopausally
• First line therapy
• Non hormonal treatment options
• Vaginal atrophy treatment duration
• Vaginal dilators
• Bladder and urinary symptoms
• Future options in testing

Links

Categories:

• Clinical Practice
• Reproduction & Development

Therapeutic Areas:

• Gynaecology & Obstetrics

Talk Citation

Publication History

• Published on September 10, 2012

Financial Disclosures

• Prof. JoAnn Pinkerton has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.