Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women

•Despite the available treatments, relief of symptoms of vulvovaginal atrophy in postmenopausal women remains unsatisfactory.•A better knowledge of the association between treatments, quality of life and symptoms may help disease management.•Postmenopausal women with vulvovaginal atrophy receiving treatment complained of higher number and more severe symptoms.•Women on systemic treatment had fewer and milder symptoms and presented with better vaginal and vulvar health.•The treatment of vulvovaginal atrophy should be initiated at early stages of the disease to prevent irreversible changes. To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women. Cross-sectional survey conducted in postmenopausal women aged 45–75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale - revised (FSDS-R) were filled out. Association between treatments for VVA and symptom frequency. Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p