Impact of postmenopausal vaginal discomfort on sex and relationships in Brazil: the CLOSER survey

Objective: The CLOSER (CLarifying Vaginal Atrophy’s Impact On SEx and Relationships) survey investigated how postmenopausal vaginal atrophy (VA) affects relationships between Brazilian women and male partners. Methods: Postmenopausal women (age 55–65 years) with VA, and male partners of women with the condition, completed an online survey on the impact of VA and local estrogen treatment on intimacy and relationships. Results: A total of 360 women and 352 men from Brazil were included. Women (83%) and men (91%) reported that they were comfortable discussing VA with their partners. Women’s key source of information on VA was health-care providers (HCPs), but 44% felt that not enough information is available. VA caused 70% of women to avoid sexual intimacy and resulted in less satisfying sex. VA had a negative impact on women’s feelings and self-esteem. Women (76%) and men (70%) both reported that treatment with vaginal estrogen improved their sexual relationship, primarily by alleviating women’s pain during sex. Women (56%) and men (59%) felt closer to each other after treatment. Conclusions: VA had a negative impact on sexual relationships for both women and men in Brazil, and reduced women’s self-confidence. Vaginal hormone therapy improved couples’ sexual relationships. A proactive attitude of HCPs is essential to educate women on VA and the potential benefits of treatment.