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.
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. 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.
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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