Experiences with Genitourinary Syndrome of Menopause and Barriers to Vaginal Estrogen Usage Reported by a National Sample of 1500 Women.

Objective: To investigate women's experiences with genitourinary syndrome of menopause (GSM) and vaginal estrogen therapy (VET), including barriers, awareness, and knowledge, and to report current trends and findings on GSM and VET to address barriers to care.

Methods: A survey on GSM and VET was posted on the ResearchMatch website. Eligible participants were women ≥ 40 years of age. Demographic information, menopausal status, current knowledge, prior experiences, and barriers associated with VET and GSM were queried. Satisfaction with their care on a 5-point Likert scale (3 coded to the neutral value with 5 being high) was assessed.

Results: Respondents (n=1,505) had a mean age of 57.6 years (SD 10.8).The majority (87%) were white, 13.7% were perimenopausal, and 872 (57.9%) were post-menopausal. 999 (69%) of women reported at least one genitourinary symptom associated with menopause. Of the 323 women who received a prescription 13% did not use it due to cost and 38.4% for fear of side effects. Among current VET users, moderate to severe concern for risks listed on the package insert were reported for breast cancer (31.4%), endometrial cancer (27.2%), and cardiovascular issues (32.1%).

Conclusion: The vast majority of survey respondents reported at least one symptom of GSM. VET usage was lower than reported GSM symptoms. Patient barriers to using VET include cost and fear of side effects. A quarter of women reported their symptoms were not adequately addressed by their provider. The majority of women using VET reported symptomatic improvement and that treatment was well-tolerated.