Atrophic vaginitis under treated under diagnosed(f)

Atrophic vaginitis under diagnosed and under treated Dr.MANINDER AHUJA FARIDABAD CHAIR PERSON GERIATRIC GYNAECOLOGY COMMITTEE OF FOGSI 05/01/10 maninder ahuja

What has changed ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Menopause – The Emerging Clinical Scenario in India ,[object Object],[object Object]

Comparison of world wide postmenopausal women over the years 05/01/10 maninder ahuja 1990 2030 World wise population 470nmillion 1.2 billion Developing countries 40% 24% Developed countries 60% 76%

FOR ALL THESE WOMEN QUALITY OF LIFE IS IMPORTANT ! 05/01/10 maninder ahuja

ATROPHIC VAGINITIS MOST UNDER REPORTED UNDER DIAGNOSED & UNDERTREATED 05/01/10 maninder ahuja

Perception about vagina ,[object Object],[object Object],[object Object],[object Object],No don’t talk! 05/01/10 maninder ahuja

WOMEN’S PERCEPTION OF VAGINA 05/01/10 maninder ahuja

EPIDEMIOLOGY OF ATROPHIC VAGINITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

ROLE OF VAGINAL PH ,[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

CONT.– VAGINAL PH ,[object Object],[object Object],[object Object],05/01/10 maninder ahuja

What other indicator of vaginal pathology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Vaginal maturation index(VMI) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

MATURATION VALUE ,[object Object],[object Object],05/01/10 maninder ahuja

IN POSTMENOPUASE ,[object Object],[object Object],[object Object],05/01/10 maninder ahuja

ATROPHIC VAGINITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Estrogen levels and vaginal symptoms 05/01/10 maninder ahuja

Inadequate hormone-dependent vaginal receptivity & seuality 05/01/10 maninder ahuja USE IT OR LOSE IT!

Other causes ,[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

other causes of vaginitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Other causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Atrophic vaginitis is progressive ,[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Management ,[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Local estrogens ,[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Urinary symptoms ,[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Low dose vaginal estrogens are effective ,[object Object],[object Object],[object Object],05/01/10 maninder ahuja

05/01/10 maninder ahuja Even when giving sytemic HRT 27% Pts. have atrophic vaginitis so local treatment is preferred.

Vaginal Estrogen Therapy for Postmenopausal Use in the United States Modified from NAMS. Menopause Practice: A Clinician's local prepaGuide, 3rd edition. Cleveland, OH: The North American Menopause Society; 2007. 05/01/10 maninder ahuja Composition Product Name Dosing Vaginal Creams 17-beta-estradiol Estrace ® vaginal cream (Warner Chilcott, Rockaway, New Jersey) Initial: 2-4 g/day for 1-2 weeks Maintenance: 1 g/day (0.1-mg active ingredient/g) Conjugated estrogens (formerly conjugated equine estrogens) Premarin ® vaginal cream (Wyeth Pharmaceuticals Inc., Philadelphia, Pennsylvania) 0.5-2 g/day (0.625-mg active ingredient/g) Vaginal Rings 17-beta-estradiol ESTRING ® (Pfizer Inc., New York, NY) Device containing 2 mg releases 7.5 µg/day for 90 days Estradiol acetate Femring ® (Warner Chilcott, Rockaway, New Jersey) Device containing 12.4 mg or 24.8 mg estradiol acetate releases 0.05 mg/day or 0.10 mg/day for 90 days (systemic levels) Vaginal Tablet Estradiol hemihydrate VAGIFEM ® (Novo Nordisk Inc., Princeton, New Jersey) Initial: 1 tablet/day for 2 weeks Maintenance: 1 tablet twice/wk (tablet containing 25.8 µg estradiol hemihydrate equivalent to 25 µg of estradiol)

Low dose vaginal estrogen and endometrial cancer ,[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Continued ,[object Object],[object Object],05/01/10 maninder ahuja

Effect on breast? ,[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

Carry home message ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/01/10 maninder ahuja

THIS IS NOT END , THIS IS THE BEGINNIG OF OUR EFFORTS FOR QUALITY CARE! 05/01/10 maninder ahuja

Atrophic vaginitis under treated under diagnosed(f)

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (16)

Similar to Atrophic vaginitis under treated under diagnosed(f)

Similar to Atrophic vaginitis under treated under diagnosed(f) (20)

More from Shambhu N

More from Shambhu N (17)

Recently uploaded

Recently uploaded (20)

Atrophic vaginitis under treated under diagnosed(f)

Editor's Notes