Current and Emerging Treatment Options for Vulvovaginal Atrophy

Abstract

Vulvovaginal atrophy in postmenopausal women is common and manifests in vaginal dryness, irritation, itching, dysuria, and dyspareunia. Treatment used to be limited to estrogen-containing regimens which pose safety concerns. Today, however, practitioners are becoming better equipped to offer a wider range of treatment options due to increased reassurance of safety for existing therapies and advances in novel treatment options. Novel options include selective estrogen receptor modulators (SERMs), tissue-selective estrogen complexes (TSECs), local androgens such as testosterone and dehydroepiandrosterone (DHEA), the peptide hormone oxytocin, as well as phytoestrogens such as genistein and daidzein found in soybeans. Nonhormonal, over-the-counter vaginal lubricants and moisturizers are additional treatment options, in particular, for women contraindicated to estrogen use.