Improving management of the genitourinary syndrome of menopause: evaluation of a health system-based, cluster-randomized intervention.

Background: Genitourinary symptoms are common in postmenopausal women and adversely affect the quality of life. National surveys and data collected from our healthcare system indicate that postmenopausal women with the genitourinary syndrome of menopause often fail to receive appropriate diagnosis or treatment.

Objective: To promote greater detection and treatment of the genitourinary syndrome of menopause, we created and tested a clinician-focused health system intervention that included clinician education sessions and a suite of evidence-based electronic health record tools.

Clinician knowledge, attitudes, and barriers to management of vulvovaginal atrophy: variations in primary care and gynecology.

Objective: Vulvovaginal atrophy is a common, but under-recognized condition affecting postmenopausal women. To guide development of an intervention to boost its detection and treatment, we surveyed primary care and gynecology clinicians practicing in an integrated healthcare system.

Methods: We constructed a three-part survey that contained (1) eight multiple-choice knowledge questions; (2) three Likert-scale questions regarding clinicians' likelihood of assessing for vulvovaginal atrophy symptoms at a routine (well) visit, confidence in advising patients about symptoms and counseling about therapy; and (3) a 12-item check list of potential barriers to diagnosis and treatment.

The impact of a group psychoeducational appointment on women with sexual dysfunction.

Objective: There is little evidence to support many treatment modalities for women with sexual dysfunction. Cognitive-behavioral therapy and bibliotherapy are associated with improved sexual outcomes. We evaluated the impact of a group psychoeducational intervention on sexual function outcome measures in women with sexual concerns.