Links accessed September 2 2023

1. LE Watjen et al. ‘Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study’. Menopause. October 2018. 25;10:1094-1104. https://journals.lww.com/menopausejournal/abstract/2018/10000/factors_associated_with_developing_vaginal_dryness.7.aspx
2. A Cagnacci et al. ‘Prevalence and association between objective signs and subjective symptoms of vaginal atrophy: the AGATA study’. October 2016. 23;10:1139-1145. https://journals.lww.com/menopausejournal/Abstract/2016/10000/Prevalence_and_association_between_objective_signs.14.aspx
3. RE Nappi et al. ‘The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey in Europe: Country-specific comparisons of postmenopausal women’s perceptions, experiences and needs’. Maturitas. September 2016. 91;81-90. https://www.maturitas.org/article/S0378-5122(16)30142-6/fulltext
4. F Palma et al. ‘The most bothersome symptom of vaginal atrophy: Evidence from the observational AGATA study’. Maturitas. February 2018. 100:18-23. https://www.maturitas.org/article/S0378-5122(17)30754-5/fulltext
5. MB Mac Bride et al. ‘Vulvovaginal Atrophy’. Concise Review for Clinicians. Mayo Clinic Proceedings. January 20109. 85;1:87-94. https://www.mayoclinicproceedings.org/article/S0025-6196(11)60314-5/fulltext
6. S Garcia de Arriba et al. ‘Vaginal hormone-free moisturising cream is not inferior to an estriol cream for treating symptoms of vulvovaginal atrophy: Prospective, randomised study’. PlosOne. May 12 2022. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266633
7. AB Smith et al. ‘The Humanistic and Economic Impact of Vaginal Dryness in Premenopausal, Perimenopausal, and Postmenopausal Women’. Journal of Women’s Health. Published online November 12 2020. 29;11: 1457-1463. https://www.liebertpub.com/doi/10.1089/jwh.2019.8001
8. U Gaspard et al. ‘A multicenter, randomized, placebo-controlled study to select the minimum effective dose of estetrol in postmenopausal participants (E4Relief): part 2—vaginal cytology, genitourinary syndrome of menopause, and health-related quality of life.’ Menopause, May 2023. 30;5:480-489. https://journals.lww.com/menopausejournal/fulltext/2023/05000/a_multicenter,_randomized,_placebo_controlled.5.aspx
9. Y Krakowsky et al. ‘The Effect of Gender-Affirming Medical Care on the Vaginal and Neovaginal Microbiomes of Transgender and Gender-Diverse People’. Front. Cell. Infect. Microbiol. January 21 2022. 11 – 769950. https://www.frontiersin.org/articles/10.3389/fcimb.2021.769950/full
10. Y-P Lin et al. ‘Vaginal pH Value for Clinical Diagnosis and Treatment of Common Vaginitis’. Diagnostics (Basel). November 2021. 11;11:1996. https://www.mdpi.com/2075-4418/11/11/1996
11. RE Nappi et al. ‘Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey’. Climacteric. November 19 2016. 19;2:188-197. https://www.tandfonline.com/doi/full/10.3109/13697137.2015.1107039
12. NHS Health A to Z. Vaginal dryness. Page last reviewed December 30 2021. https://www.nhs.uk/conditions/vaginal-dryness/
13. Cleveland Clinic. Vaginal Dryness. Page last reviewed July 26 2022. https://my.clevelandclinic.org/health/symptoms/21027-vaginal-dryness
14. British Sjögren’s Syndrome Association. Information sheet. https://www.bssa.uk.net/information.asp
15. MJ Hale et al. ‘Tamoxifen related side effects and their impact on breast cancer incidence: A retrospective analysis of the randomised IBIS-I trial’. The Breast. October 31 2020. 54:216-221. https://www.thebreastonline.com/article/S0960-9776(20)30206-X/fulltext
16. C Domoney et al. ‘Symptoms, attitudes and treatment perceptions of vulvo-vaginal atrophy in UK postmenopausal women: Results from the REVIVE-EU study’. Post Reproductive Health. July 4 2020. 26;2. https://journals.sagepub.com/doi/10.1177/2053369120925193
17. NICE guideline NG23. Menopause: diagnosis and management. Published November 12 2015, last updated December 5 2019. https://www.nice.org.uk/guidance/ng23
18. European Medicines Agency. ‘PRAC confirms four-week limit for use of high-strength estradiol creams’. Press release January 17 2020. https://www.ema.europa.eu/en/news/prac-confirms-four-week-limit-use-high-strength-estradiol-creams
19. British Menopause Society. Confusion over vaginal oestrogen. January 22 2020. https://thebms.org.uk/2020/01/confusion-over-vaginal-estrogen/
20. Royal United Hospitals Bath. Patient information. Management of vaginal dryness and breast cancer. June 13 2023. Ref: RUH BRU/028. https://www.ruh.nhs.uk/patients/patient_information/BRU028_Vaginal_dryness_and_breast_cancer.pdf
21. The Menopause Charity. Vaginal Dryness. https://www.themenopausecharity.org/2021/10/21/vaginal-dryness-2/
22. NICE. BNF. Treatment summaries. Vaginal and vulval conditions. https://bnf.nice.org.uk/treatment-summaries/vaginal-and-vulval-conditions/
23. emc. Intrarosa 6.5mg pessary. SmPC. Last updated on emc February 25 2022. https://www.medicines.org.uk/emc/product/9986/
24. NHS Business Services Authority. National Health Service England and Wales. Elecronic Drug Tariff. https://www.drugtariff.nhsbsa.nhs.uk/
25. Public Health Scotland. Scottish Drug Tariff. https://www.isdscotland.org/health-topics/prescribing-and-medicines/scottish-drug-tariff/
26. P Stute et al. ‘Efficacy and safety of non-hormonal remedies for vaginal dryness: open, prospective, randomized trial’. Climacteric. May 22 2015. 18;4:582-589. https://www.tandfonline.com/doi/full/10.3109/13697137.2015.1036854
27. D Edwards & N Panay. ‘Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?’. Climacteric. December 26 2015. 19;2:151-161. https://www.tandfonline.com/doi/full/10.3109/13697137.2015.1124259
28. C Campagnaro M dos Santos et al. ‘Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review’. The Journal of Sexual Medicine. January 2021. 18;1:156-166.30

30. emc. https://www.medicines.org.uk/emc

31. NICE. BNF. Ospemifene. https://bnf.nice.org.uk/drugs/ospemifene/

32. emc. SmPC. Senshio 60 mg film-coated tablets. Last updated on emc on March 28 2023 https://www.medicines.org.uk/emc/product/9417

33. Health Improvement Scotland/Scottish Medicines Consortium. Ospemifene (Senshio). September 9 2019. https://www.scottishmedicines.org.uk/medicines-advice/ospemifene-senshio-full-smc2170/

34. NA Philips & GA Bachmann. The genitourinary syndrome of menopause. Menopause. May 2021. 28;5:579-588. https://journals.lww.com/menopausejournal/abstract/2021/05000/the_genitourinary_syndrome_of_menopause.16.aspx

35. Z Mei & D Li. ‘The role of probiotics in vaginal health’. Front. Cell. Infect. Microbiol. July 28 2022. 12;963868. https://www.frontiersin.org/articles/10.3389/fcimb.2022.963868/full

36. S Alvisi et al. ‘Short-Term Efficacy and Safety of Non-Ablative Laser Treatment Alone or with Estriol or Moisturizers in Postmenopausal Women with Vulvovaginal Atrophy’. The Journal of Sexual Medicine. May 2022. 19;5:761–770. https://academic.oup.com/jsm/article-abstract/19/5/761/6961270

37. M Kiesel et al. ‘Treatment of Vulvovaginal Atrophy with Fractional CO2 Laser: Evaluating Real-World Data’. Photobiomodulation, Photomedicine, and Laser Surgery. November 10 2021. 29;11:716-724. https://www.liebertpub.com/doi/10.1089/photob.2021.0058

38. emc. SmPC. Gina 10 micrograms vaginal tablets. Last updated on emc on July 25 2022 https://www.medicines.org.uk/emc/product/13930/smpc

39. MHRA. Consultation Outcome. Proposal to make Gina 10 microgram vaginal tablets (Estradiol) available from pharmacies. Updated July 20 2022. https://www.gov.uk/government/consultations/consultation-on-proposal-to-make-gina-10-microgram-vaginal-tablets-estradiol-available-from-pharmacies/proposal-to-make-gina-10-microgram-vaginal-tablets-estradiol-available-from-pharmacies