ISSM University

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Topic description:
This module serves as an introduction to hormone-dependent sexual dysfunctions in women, including genitourinary syndrome of menopause (GSM) and vestibulodynia. Included is information related to sexual function in women with breast cancer and considerations for the use aromatase inhibitors and specific estrogen receptor modulators (SERMs) in these patients.

Video segments in the learning module:
- Video 1: Genitourinary Syndrome of Menopause – Prevalence, Symptoms and Treatments
- Video 2: Vestibulodynia – Epidemiology and Diagnosis
- Video 3: Breast Cancer, Aromatase Inhibitors and SERMs

Faculty Information
James A. Simon, MD
IntimMedicine Specialists
Clinical Professor of Obstetrics & Gynecology
The George Washington University School of Medicine
Washington, District of Columbia, USA

Andrew T. Goldstein, MD, FACOG
Director, Centers for Vulvovaginal Disorders
Washington, District of Columbia and New York, New York, USA
Clinical Professor
George Washington University School of Medicine
Washington, District of Columbia, USA

Tami Rowen, MD
Assistant Professor of Obstetrics & Gynecology
University of California, San Francisco
San Francisco, California, USA

Best practice:
Provide patients and health care professionals (HCPs) accurate information to facilitate their decision-making process as it pertains to the diagnosis, assessment, and treatment of Genitourinary Syndrome of Menopause (GSM; previously known as VulvoVaginal Atrophy; VVA). Women requesting birth control should be counseled on the potential sexual effects of hormonally-based contraception.

Current practice:
HCPs restrict their recommendations on the use of menopausal hormone therapy, including local vaginal estrogen, fearing the perceived increased risks and resulting in many women not having their symptoms of GSM adequately addressed. Positive and negative sexual effects of various birth control choices are seldom a part of routine obstetrics/gynecology, primary care or urology practice before a birth control choice is made.

Resulting gaps:
There is often a discrepancy between the actual evidence regarding the safety of local vaginal estrogen therapy, as well other non-hormonal options for GSM and what HCPs recommend to their patients for symptom relief. Women may be unaware that their birth control method may be contributing to sexual dysfunction.

Outcome indicated/Improvement in:
By reviewing the evidence-based data regarding the efficacy, risks, and benefits of both hormonal and non-hormonal GSM treatment options, HCPs can better educate their patients and facilitate the decision-making process when it comes to managing this common condition. Fair, balanced scientific education about contraceptive methods and sexual function should be provided to patients when discussing contraception.

Learning objectives:
(1) Recognize the clinical manifestations of GSM and the underlying pathology and apply evidence-based treatment options, both hormonal and non-hormonal, to the management of GSM.
(2) Describe the potential positive and negative sexual health effects of various contraceptive methods.

Medical health care practitioners (MDs, DOs, PAs, NPs, etc.) in any field (Sexual Medicine, Obstetrics & Gynecology, Internal Medicine, Family Medicine, Urology, etc.) who would like to address sexual health in caring for their female patients.

ISSWSH Learner Notification

Hormone-Dependent Sexual Dysfunctions in Pre- and Post-menopausal Women (Including GSM and OCP Use)
Dr. J. Simon, Dr. A. Goldstein and Dr. T. Rowen
September 01, 2019 - September 01, 2021
Online

Acknowledgement of Financial Commercial Support
AMAG Pharmaceuticals, Inc.

Acknowledgement of In-Kind Commercial Support
No in-kind commercial support was received for this educational activity.

Satisfactory Completion
Learners must listen to each self-directed audio recording while following along with the visual slides/read the articles, pass the post-test with a score of 80% or higher and complete an evaluation form to receive a certificate of completion. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.

Physicians

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and the International Society for the Study of Women’s Sexual Health, Inc. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Amedco LLC designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Objectives - After attending this program you should be able to:
1. Recognize the clinical manifestations of GSM and the underlying pathology and apply evidence-based treatment options, both hormonal and non-hormonal, to the management of GSM.
2. Describe the potential positive and negative sexual health effects of various contraceptive methods.

The following table of disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content disclosed to Amedco. All of these relationships were treated as a conflict of interest, and have been resolved. (C7 SCS 6.1-­‐6.2, 6.5)
All individuals in a position to control the content of CE are listed below.

First

Last

Commercial Interest

A.

Goldstein

AMAG: Scientific/Medical Advisory Board Member, Strategic Sciences and Technology: Consultant, Endoceutics: Research Grant Overall Principal Investigator, Ipsen: Research Grant Overall Principal Investigator, Ipsen: Scientific/Medical Advisory Board Member, Lupin: Scientific/Medical Advisory Board Member, Elen: Research Grant Overall Principal Investigator

T.

Rowen

Genomic Health: Consultant

J.A.

Simon

Grant/Research Support: AbbVie, Inc., Allergan, Plc, Agile Therapeutics, Bayer Healthcare LLC., Endoceutics, Inc., GTx, Inc., Ipsen, Myovant Sciences, New England Research Institute, Inc., ObsEva SA, Palatin Technologies, Symbio Research, Inc., TherapeuticsMD, Viveve Medical. Consultant/Advisory Board: AbbVie, Inc., Allergan, Plc, AMAG Pharmaceuticals, Inc., Amgen, Ascend Therapeutics, Bayer HealthCare Pharmaceuticals Inc., CEEK Enterprises, LLC, Covance Inc., Daré Bioscience, Duchesnay USA, Hologic Inc., KaNDy/NeRRe Therapeutics Ltd., Mitsubishi Tanabe Pharma Development America, Inc., ObsEva SA, Sanofi S.A., Shionogi Inc., Sprout2, Inc., TherapeuticsMD Speakers’ Bureau: AbbVie, Inc., AMAG Pharmaceuticals, Inc., Duchesnay USA, Novo Nordisk, Shionogi Inc. Stock Shareholder: Sermonix Pharmaceuticals (direct purchase)

Hormone-Dependent Sexual Dysfunctions in Pre- and Post-menopausal Women (Including GSM and OCP Use)
Self-assessment & Certificate

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