SPONSORED POST by AMAG Pharmaceuticals, Inc.
Uncover the painful truth about dyspareunia
Declining hormone levels in menopause cause millions of women to experience uncomfortable vulvovaginal atrophy, often resulting in dyspareunia and a withdrawal from sexual activity and intimacy.1,2 In fact, the majority of affected women and their partners report an avoidance of intimacy because of dyspareunia—with one-fourth of these women believing intimacy with their partner is no longer possible.2
Uncover the role of both androgens and estrogens
Prior to menopause, the ovaries are the primary source of sex steroids, providing trophic support to the vaginal wall, with the adrenal glands serving as a secondary source of inactive substrate for local sex hormone production.3 But research has shown that the adrenals, and to some extent the ovaries, also produce an important inactive sex steroid precursor known as dehydroepiandrosterone (DHEA).4 Before menopause, these endogenous sex hormones work to maintain heathy layers of the vaginal wall that help facilitate comfortable sex.5-7
Uncover how changes in sex hormones can lead to changes in vaginal tissues and walls
After menopause, circulating sex hormones from the ovaries drop to biologically insignificant levels.3,8 DHEA now becomes a source of estrogens and androgens via steroidogenesis.3,8 By the time most women reach 50, the adrenal glands produce significantly less DHEA than they used to.3,8 These reduced DHEA levels are often insufficient to maintain the vaginal wall epithelium— and can contribute to dyspareunia.3
However, a woman’s vaginal epithelium, even after menopause, maintains its ability to generate estrogens and androgens intracellularly.8
Uncover a better understanding of local steroidogenesis
Ongoing research continues to uncover the fundamental science of vaginal physiology and histology, before and after menopause, and broadens our understanding of the vaginal epithelium’s innate potential for local steroidogenesis.8 When all is revealed, we may have uncovered a better understanding of the physiologic processes that cause dyspareunia after menopause.
To uncover even more, click on the Uncover DHEA video, visit ACOG Booth #137, and visit UncoverDHEA.com
1. Wysocki S, Kingsberg S, Krychman M. Clin Med Insights Reprod Health. 2014;8:23-30. 2. Nappi RE, Kingsberg S, Maamari R, Simon J. J Sex Med. 2013;10(9):2232-2241. 3. Labrie F. Menopause Manag. 2010;19:14-24. 4. Labrie F, Archer DF, Koltun W, et al. Menopause.
2016;23(3):243-256. 5. Goldstein I. Female Urology. 3rd ed. Philadelphia, PA: Saunders Elsevier;2008:505-524. 6. Goldstein I.J Womens Health (Larchmt). 2010;19(3):425-432.
7. Jannini EA, d’Amanti G, Lenzi A. Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment. Boca Raton, FL: CRC Press;2005:125-133. 8. Archer DF, Labrie F, Bouchard C, et al. Menopause. 2015;22(9):950-963. ©2017 AMAG Pharmaceuticals, Inc. All rights reserved. NP-INR-US-00007