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Clarifying Vaginal Atrophys Impact on Sex and Relationships (CLOSER) survey: emotional and physical impact of vaginal discomfort on North American postmenopausal women and their partners

Simon, James A. MD, CCD, NCMP, FACOG1; Nappi, Rossella E. MD, PhD2; Kingsberg, Sheryl A. PhD3; Maamari, Ricardo MD, NCMP4; Brown, Vivien MD, CM, CCFP, FCFP, NCMP5

doi: 10.1097/GME.0b013e318295236f
Original Articles

Objective: This study aims to determine the emotional and physical impact of vaginal atrophy on North American postmenopausal women and their male partners.

Methods: A weighted sample of 1,000 married or cohabiting North American postmenopausal women aged 55 to 65 years with vaginal discomfort and 1,000 male partners of postmenopausal women aged 55 to 65 years who experienced vaginal discomfort participated in the Clarifying Vaginal Atrophy’s Impact on Sex and Relationships (CLOSER) online survey to determine the impact of vaginal discomfort and local estrogen therapy on intimacy, relationships, and women’s self-esteem.

Results: Vaginal discomfort caused most surveyed North American women to avoid intimacy (58%), experience loss of libido (64%), and experience pain associated with sex (64%). Most surveyed North American men also believed that vaginal discomfort caused their partners to avoid intimacy (78%), experience loss of libido (52%), and find sex painful (59%). Approximately 30% of North American women and men cited vaginal discomfort as the reason they ceased having sex altogether. North American women who used local estrogen therapy to treat their vaginal discomfort reported less painful sex (56%), more satisfying sex (41%), and improved sex life (29%). Most men reported looking forward to having sex (57%) because of their partner’s use of local estrogen therapy.

Conclusions: Local estrogen therapy ameliorates the negative impact of vaginal atrophy on the intimate relationships of North American postmenopausal women and their male partners. Additional education and awareness efforts about the symptoms of and available treatments for vaginal atrophy may be of further benefit to North American partners.

From the 1Women’s Health and Research Consultants, George Washington University School of Medicine, Washington, DC; 2Research Center for Reproductive Medicine, Department of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy; 3Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Cleveland, OH; 4Clinical Development, Medical and Regulatory Affairs, Novo Nordisk Inc, Princeton, NJ; and 5Family Medicine, University of Toronto, Toronto, ON, Canada.

Received December 20, 2012; revised and accepted March 28, 2013.

Funding/support: The Clarifying Vaginal Atrophy’s Impact on Sex and Relationships (CLOSER) survey was commissioned by Novo Nordisk A/S.

Financial disclosure/conflicts of interest: J.A.S. has served (within the last year) or is currently serving as consultant to or on the advisory boards of Abbott Laboratories, Agile Therapeutics Inc, Amgen Inc, Ascend Therapeutics, BioSante, Depomed Inc, Intimina by Lelo Inc, MD Therapeutics, Merck, Novo Nordisk, Novogyne, Pfizer Inc, Shionogi Inc, Slate Pharmaceuticals Inc, Sprout Pharmaceuticals, Teva Pharmaceutical Industries Ltd, Warner Chilcott, and Watson Pharmaceutical Inc. J.A.S. has received or is currently receiving grant/research support from BioSante, EndoCeutics Inc, Novo Nordisk, Novogyne, Palatin Technologies, Teva Pharmaceutical Industries Ltd, and Warner Chilcott. He has also served or is currently serving on the speakers bureaus of Amgen Inc, Merck, Novartis, Novo Nordisk, Novogyne, Teva Pharmaceutical Industries Ltd, and Warner Chilcott. J.A.S. is currently the chief medical officer for Sprout Pharmaceuticals. In the past 2 years, R.E.N. had a financial relationship (lecturer, member of advisory boards, and/or consultant) with Bayer-Schering Pharma, Eli Lilly, Gedeon Richter, Merck Sharpe & Dohme, Novo Nordisk, Pfizer Inc, and Teva/Theramex. S.A.K. has served as consultant to Novo Nordisk, Pfizer, and Shionogi, and has also served on the advisory boards of Novo Nordisk. R.M. is an employee of Novo Nordisk Inc. V.B. has served on the speakers bureau of Novo Nordisk.

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Address correspondence to: James A. Simon, MD, Women’s Health and Research Consultants, Suite 450, 1850 M Street, NW, Washington, DC 20036. E-mail: jsimon@JamesASimonMD.com

© 2014 by The North American Menopause Society.