International Menopause Society Calls Upon Medical Community to Improve the Vaginal Health of Postmenopausal Women

New Treatment Recommendations Urge Women and Doctors to Overcome the Taboo of Postmenopausal Vaginal Atrophy

LONDON, October 7, 2010 - To mark World Menopause Day on 18th October 2010, the International
Menopause Society (IMS) is launching new Recommendations for the management
of postmenopausal vaginal atrophy, a distressing condition that will affect
up to half of women after menopause.[1] This new guidance is essential as,
according to new research, one in two women with vaginal atrophy (VA) will
live with their condition unnecessarily for over three years, despite
effective treatments being available. The data suggests that this is largely
due to poor awareness and understanding of the condition among women, and
because VA is a "taboo" subject - even between a doctor and patient.

VA is characterised by symptoms including vaginal dryness, itching,
increased tendency of infection and pain during sex. It occurs when the
vaginal walls become thin, fragile and inflamed due to a reduction of
oestrogen in the body.[2] While VA has an obvious impact on sexual intimacy,
it also has negative consequences for a woman's personal relationships,
self-esteem and overall quality of life. If left untreated, VA can lead to
serious long-term urogenital problems, including incontinence.[3] However,
despite these negative implications, just one in four women will actually
speak to her doctor about VA.1

Dr David Sturdee, President of the IMS and lead author of the
Recommendations, said, "It is unacceptable that women are living with VA for
so long, when various safe and effective treatments are available. So, to
mark World Menopause Day, the IMS is launching the new Recommendations and is
calling upon doctors to proactively raise the topic of vaginal health with
postmenopausal patients. Women with VA are also encouraged to seek medical
advice, as there is absolutely no need for them to continue suffering in
silence."

The Recommendations note that many women may not report VA symptoms to
their doctor because of concerns about taking hormone replacement therapy
(HRT). Some of this reluctance is due to the adverse publicity for HRT over
recent years, but, regardless of whether these concerns are justified, local
oestrogen therapy for VA, which delivers a low dose of hormone directly to
the vagina, is not associated with the possible risks of systemic (oral) HRT.
Doctors need to ensure patients fully understand this, so that they can
benefit from VA treatment.

In addition, women with VA may have cultural or religious reasons for not
talking to their doctor about their symptoms, and women in general may be
understandably reluctant to discuss such private matters, particularly with a
male doctor. The Recommendations offer advice and guidance to healthcare
professionals, to enable them to initiate a successful dialogue with their
patient. Most women express relief and respond positively when a doctor
initiates the conversation about this topic.

Survey highlights challenges in awareness and communication about VA

Results from the VIVA (Vaginal Health: Insights, Views & Attitudes)[4]
Survey, an international study involving over 3,500 postmenopausal women,
show that 96% of postmenopausal women are incorrectly attributing VA symptoms
to other conditions such as thrush or a bladder infection. The data also show
that women do not understand that VA is a chronic condition, and are
resorting to short-term symptom relief using lubricants and moisturisers,
when treatment for the underlying cause is available from the doctor.

The VIVA Survey also found that half of women would not discuss VA
symptoms with their physician. In addition, only two in five women would talk
to their spouse or partner about VA and two-thirds reported that their mother
never spoke to them about menopause, suggesting that VA is still very much a
taboo subject.

Dr Rossella Nappi, Associate Professor of Obstetrics and Gynecology,
Research Center for Reproductive Medicine and Director of the Gynecological
Endocrinology & Menopause Unit, University of Pavia (Italy), said, "It is so
sad that women are suffering in silence with this condition; many believe
that VA is just an inevitable part of menopause and that they have no choice
but to live with the consequences. However, this is not the case, so it is
vital that a dialogue about vaginal health is initiated with postmenopausal
patients as part of routine."

The Recommendations for the management of postmenopausal vaginal atrophy
are published in the December 2010 edition of Climacteric, and are available
at www.imsociety.org. Patient education materials are also available.

NOTES TO EDITORS

A webcast of the IMS press briefing for World Menopause Day will be
available from

Monday 11th October at www.imsociety.org.

About the IMS

The International Menopause Society (IMS) was established in 1978 and was
the first menopause society in the world. At the time, it signalled to the
medical community that there was a need to address specific gender-based and
menopause-based issues, which until then had not been regarded as important.

In the following years, many national and regional menopause societies
have been formed, but the IMS remains the only society with a global
responsibility and, as such, is a leading resource to which the media as well
as the medical professionals look for opinion and guidance. This has been
particularly important in recent years when the merits of hormone therapy
have come under intense debate.

About World Menopause Day

World Menopause Day on October 18th was initiated by the IMS, in
collaboration with the World Health Organization, as an opportunity to alert
the world to the importance of the menopause and the impact that it has on
the lives of so many women all around the world. In observation of the Day,
the IMS and the member national societies of CAMS, the Council of Affiliated
Menopause Societies, distribute materials and organise activities to inform
women about menopause, its management and the impact of oestrogen loss.

About the VIVA (Vaginal Health: Insights, Views & Attitudes) Survey

The VIVA survey was commissioned by Novo Nordisk and conducted by
Strategy One, an independent market research company. The survey was
conducted online in August 2010, with results received from 3,520 female
respondents aged 55-65 years old from Great Britain, Sweden, Denmark,
Finland, Norway, Canada, and the United States of America. The aim of the
survey was to evaluate the attitudes of postmenopausal women on the impact of
Vaginal Atrophy (VA) and menopause on different aspects of their lives and
understand the barriers and challenges to seeking advice and treatment.

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[1] Sturdee DW, Panay N. Recommendations for the management of
postmenopausal vaginal atrophy. Climacteric. 2010;13:

[2] Clinic: Vaginal Atrophy Definition. Available at:
www.mayoclinic.com/health/vaginal-atrophy/DS00770 Last accessed July
2010

[3] Hextal A. Oestrogens and lower urinary tract function. Maturitas
2000; 36: 83-92.

[4] Research conducted by an independent research agency in the US,
Canada, UK, Finland, Sweden, Denmark and Norway and is sponsored by an
unrestricted educational grant from Novo Nordisk.

Media enquiries contact: Catherine Taman, Edelman, T: +44(0)20-3047-2078, catherine.taman at edelman.com