{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:31:27Z","timestamp":1791901887062,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Vulvovaginal atrophy (VVA) is a condition associated with decreased estrogenization of the vaginal tissue, which can result in vaginal dryness, irritation, and dyspareunia. This study quantified the burden associated with VVA symptoms across the United States and Europe and compared this burden with other chronic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data were analyzed from the International Women's Health Study, a cross-sectional Internet survey of women aged 40\u201375 years in the United States and Europe. All postmenopausal women aged 40\u201375 years were included in the analyses (Germany\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =970, Spain\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =294, France\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =1054, Italy\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =387, United Kingdom\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =1096, United States\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =3267). VVA symptom severity (none, mild, moderate, severe) was assessed using the Menopause Rating Scale and included in general linear models to predict EuroQol-5D (EQ-5D) quality of life scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The prevalence of VVA symptoms varied between 40.00% (Germany) and 54.42% (Spain), with half of women reporting their symptoms as either moderate or severe. Pooling data from all countries together, each incremental level of severity (none through severe) was associated with a significant decrement in EQ-5D scores (none=0.84 vs. mild=0.81 vs. moderate=0.79 vs. severe=0.74;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.05). The decrements in EQ-5D scores associated with moderate to severe VVA symptoms were comparable to those observed in other serious conditions including arthritis, chronic obstructive pulmonary disease, asthma, and irritable bowel syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>VVA symptoms are associated with clinically meaningful decrements in quality of life that may be comparable to serious conditions such as arthritis, chronic obstructive pulmonary disease, asthma, and irritable bowel syndrome. Improved management of VVA symptoms may be required to alleviate the impact of VVA on the quality of life of affected women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2014.5177","type":"journal-article","created":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T16:47:39Z","timestamp":1437583659000},"page":"713-722","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":112,"title":["The Association Between Vulvovaginal Atrophy Symptoms and Quality of Life Among Postmenopausal Women in the United States and Western Europe"],"prefix":"10.1177","volume":"24","author":[{"given":"Marco","family":"DiBonaventura","sequence":"first","affiliation":[{"name":"Kantar Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Luo","sequence":"additional","affiliation":[{"name":"Pfizer Inc.,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Moffatt","sequence":"additional","affiliation":[{"name":"Pfizer Inc.,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Bushmakin","sequence":"additional","affiliation":[{"name":"Pfizer Inc.,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Kumar","sequence":"additional","affiliation":[{"name":"Kantar Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Bobula","sequence":"additional","affiliation":[{"name":"Pfizer Inc.,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,9,1]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"3090","article-title":"Diagnosis and treatment of atrophic vaginitis","volume":"61","author":"Bachmann GA","year":"2000","unstructured":"Bachmann GA, , Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. American family physician., 2000; 61:3090\u20133096.","journal-title":"American family physician."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0413"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2009.01335.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0b013e318287342d"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2010.08.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12190"},{"key":"e_1_3_2_8_2","article-title":"Vaginal Health: Insights, Views & Attitudes (VIVA) survey\u2014Canadian cohort","author":"Frank SM","year":"2012","unstructured":"Frank SM, , Ziegler C, , Kokot-Kierepa M, , Maamari R, , Nappi RE. Vaginal Health: Insights, Views & Attitudes (VIVA) survey\u2014Canadian cohort. Menopause Int, 2012 Nov 30. [Epub ahead of print].","journal-title":"Menopause Int"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1754045313484139"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2013.850480"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e3182227ebd"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e31815a5168"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0b013e318295236f"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.4770150406"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S39027"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-199807000-00005"},{"key":"e_1_3_2_17_2","first-page":"16","article-title":"[Evaluation of climacteric symptoms (Menopause Rating Scale)]","volume":"116","author":"Hauser GA","year":"1994","unstructured":"Hauser GA, , Huber IC, , Keller PJ, , Lauritzen C, , Schneider HP. [Evaluation of climacteric symptoms (Menopause Rating Scale)]. Zentralblatt fur Gynakologie, 1994; 116:16\u201323.","journal-title":"Zentralblatt fur Gynakologie"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-2-67"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3109\/07853890109002087"},{"key":"e_1_3_2_21_2","unstructured":"EuroQoL Group.. EQ-5D-3L Value sets. 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