- The female vagina, bladder and urethra are particularly sensitive to the decline in oestrogen that occurs at menopause.

- Declining oestrogen causes thinning of the walls and muscular layers of these parts of the body and loss of support tissue – a process known as atrophy. It also results in decreased secretions, which causes vaginal dryness.

- About half of all postmenopausal women will experience symptoms related to vaginal atrophy, affecting sexual function and quality of life.

- Approximately three quarters of women with vaginal atrophy will experience uncomfortable vaginal dryness. Other symptoms include pain during sexual intercourse and vaginal itching, discharge and pain.

- Unlike other symptoms of menopause, such as hot flushes and night sweats, which resolve spontaneously in time, atrophic symptoms affecting the vagina and lower urinary tract are often progressive and frequently require treatment.

- However, only one in four women seek medical advice for uncomfortable symptoms of vaginal atrophy. Reasons for this include embarrassment and the belief that symptoms will get better by themself.

- Vaginal health plays a crucial role in sexual health. Women with vaginal dryness also frequently experience other sexual symptoms, such as reduced sexual desire, poor arousal and orgasm, and impaired sexual satisfaction.

- Vaginal dryness can be helped by simple lubricants, but the best and most logical treatment for urogenital atrophy is to use locally applied (topical) oestrogen. This is safe, effective and has few contraindications.

- A study including 500 menopausal women (who had experienced vaginal discomfort) and their male partners showed the following results:

- Over two-thirds of women (69%) and more than three-quarters of men (76%) considered that vaginal discomfort resulted in avoidance of physical intimacy, mainly due to concern about sex being painful (women 63%; men 61%).

- Almost one out of five women considered vaginal discomfort had created emotional distance between them and their partners. One reason for this was that the women believed their partners did not understand the changes they were experiencing, causing them to feel isolated from their partners.

- Fourteen per cent of men reported failing to understand what was happening to their partners’ bodies, thereby feeling isolated themselves.

- One third of the women did not feel comfortable discussing vaginal discomfort with their partner.

- 40% of women who used local oestrogen therapy reported feeling 'happy that their body was working again'.

- Approximately one third of women and one third of the men reported feeling emotionally closer to their partner after the female partner used local oestrogen.

- In a study of women who had tried various forms of local oestrogen treatment, vaginal tablets were the most preferred option because they were effective, convenient and cleaner to apply. Women also reported a longer duration of tablet use in comparison to vaginal cream.

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