Postmenopausal Vaginal Atrophy (PVA) refers to decrease in estrogen
production most commonly after menopause and the condition is also
called as vaginal Atrophy. Less estrogen leads to drying, thinning,
and decreased elasticity of vaginal tissues. Various other causes
leading to decrease in estrogen levels include perimenopause, during
breast feeding, surgical menopause, pelvic radiation therapy and
chemotherapy and also as a side effect of breast cancer hormonal
treatment. Symptoms of vaginal Atrophy include burning, redness,
itching, dyspareuia, and irritation. Vaginal atrophy is a common
result of the treatment of many gynecological cancers. Postmenopausal
vaginal Atrophy is known to occur commonly due to increase in life
expectancy and lengthening of average lifespan post menopause.
Diagnosis for PVA includes pelvic examination, vaginal smear test,
vaginal activity test, blood test and urine test.
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The treatment generally involves use of hormonal replacement therapy,
estrogen creams, pessaries or lubricating gels. The sensitivity of
urogenital tract to the decline in estrogen levels leads to symptoms
related to vaginal atrophy, and is also known to affect sexual
function and quality of life in about half of all postmenopausal
women. Most commonly, vaginal atrophy becomes evident 4–5 years
post the menopause. The principles of treatment in women with
established vaginal atrophy are restoration of urogenital physiology,
and alleviation of symptoms.
The global PVA drugs market can be segmented based on therapy type,
pipeline analysis and geography. Therapy type includes estrogen based
and non estrogen based. Commonly used estrogen based therapy includes
topical estrogen and systemic estrogen. Various formulations used in
topical therapy include creams, tablets and rings, while systemic
therapy includes oral administration of estradiol. Vaginal creams and
vaginal tablets are the most commonly used therapies. However,
topical estrogen treatment is known to cause endometrial cancer in
few women Oral estradiol use since associated with adverse events
such as deep vein thrombosis, stroke, Coronary Heart Disease (CHD),
and invasive breast cancer is least preferred treatment option.
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Recent novel drugs in non estrogen category include Osphena
(osphemifene), BZA/CE (bazedoxifene + conjugated estrogens) and
Vaginorm (prasterone). Estrogen replacement therapy producst include
Premarin, Vagifem, Estrace, Estring and Femring. Geographically, the
global PVA drugs market can be segmented into four major regions,
namely, North America, Europe, Asia-Pacific and Rest of the World.
Historically, PVA has witnessed several unmet needs due to low
diagnosis rate, poor patient compliance and the risk associated with
the existing treatment to cause different cancers. Also, the
reluctant nature of women to discuss with healthcare professionals
regarding symptoms such as vaginal burning vaginal dryness, and
discomfort during intercourse was known to result in low diagnosis
and treatment-seeking rate. However with the advent of novel drugs
with improved safety are expected to tap the unmet needs by
increasing the number of women undergoing treatment. Increase in
awareness of postmenopausal vaginal Atrophy amongst patient as well
as physicians regarding the need for treatment, shift towards use of
non-estrogen based therapies and conducting awareness campaigns is
likely to boost the PVA drugs market during the forecast period.
Novel drug are further expected to improve patient compliance through
enhanced safety and efficacy profiles and therefore drive the global
postmenopausal Atrophy drugs market.
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Some of the key players contributing to the global postmenopausal
vaginal Atrophy drugs market include Actavis plc, Bionovo, Inc.,
Endoceutics, Inc., Novo Nordisk A/S, Pfizer, Inc., Teva
Pharmaceuticals Ltd., Therapeutics MD, Inc., and Shionogi & Co.
Ltd.
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