@article{3076347,
    title = "Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide",
    author = "Hirschberg, A.L. and Bitzer, J. and Cano, A. and Ceausu, I. and Chedraui, P. and Durmusoglu, F. and Erkkola, R. and Goulis, D.G. and Kiesel, L. and Lopes, P. and Pines, A. and van Trotsenburg, M. and Lambrinoudaki, I. and Rees, M.",
    journal = "Maturitas",
    year = "2021",
    volume = "148",
    pages = "55-61",
    publisher = "Elsevier Ireland Ltd",
    issn = "0378-5122",
    doi = "10.1016/j.maturitas.2021.04.005",
    keywords = "emollient agent;  estrogen;  lubricating agent;  estrogen, application site irritation;  Article;  breast cancer;  breast tenderness;  cancer adjuvant therapy;  cancer risk;  candidiasis;  cardiovascular disease;  cardiovascular risk;  consensus;  drug efficacy;  drug safety;  drug use;  endometrium cancer;  female;  female genital tract cancer;  hip fracture;  human;  information retrieval;  low drug dose;  Medline;  meta analysis (topic);  ovary cancer;  peritoneum cancer;  postmenopause;  publication;  randomized controlled trial (topic);  recurrent disease;  systematic review (topic);  topical treatment;  urinary tract infection;  urine incontinence;  uterine cervix cancer;  uterine tube tumor;  uterus sarcoma;  vagina atrophy;  vagina bleeding;  vagina cancer;  vagina discharge (disease);  vagina mycosis;  vaginitis;  venous thromboembolism;  atrophy;  expert witness;  intravaginal drug administration;  practice guideline;  quality of life;  vagina disease;  vulva disease, Administration, Intravaginal;  Atrophy;  Estrogens;  Expert Testimony;  Female;  Humans;  Postmenopause;  Practice Guidelines as Topic;  Quality of Life;  Vaginal Diseases;  Vulvar Diseases",
    abstract = "Introduction: Vulvovaginal atrophy (VVA) is a chronic condition caused by estrogen deficiency. It affects around 50% of postmenopausal women, reducing their general and sexual quality of life as well as the quality of their personal relationships. Aim: The aim of this clinical guide is to set out an individualized approach to the management of VVA with topical estrogens and non-hormonal preparations. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: An individualized approach is required for the management of VVA. Topical low-dose estrogens are effective and also alleviate urinary incontinence and prevent recurrent urinary tract infections. Women should not be denied long-term use of topical estrogens as long as they feel that this treatment is of benefit to them, because the safety data are reassuring. Non-hormonal preparations (lubricants and moisturizers) should be the first-line treatment for VVA in women taking adjuvant endocrine therapies for cancers considered to be hormone-dependent. They can be used over the long term. © 2021"
}