Clinical manifestations and evaluation of postmenopausal vulvovaginal atrophy

Pérez‐López, Faustino R.; Vieira‐Baptista, Pedro; Phillips, Nancy; Cohen-Sacher, Bina; Fialho, Susana Cristina Aidé Viviani; Stockdale, Colleen K.

doi:10.1080/09513590.2021.1931100

Cited by 27 publications

(26 citation statements)

References 53 publications

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“…In women undergoing hysterectomy, the onset of menopause occurs artificially, although the ovaries keep functioning. In situations of bilateral oophorectomy, menopause may be accompanied by the clinical manifestations of hypoestrogenism, occurring more frequently and more intensely than in menopause natural (5)(6)(7)(8).…”

Section: Physiopathologymentioning

confidence: 99%

Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

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Vieira‐Baptista

et al. 2021

Front. Reprod. Health

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Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27–84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.

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Section: Physiopathologymentioning

confidence: 99%

Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

Sarmento

Costa

Vieira‐Baptista

et al. 2021

Front. Reprod. Health

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“…Treatment efficacy is evaluated in clinical trials using a range of measurements that represent the changes occurring in the vagina in response to the presence or absence of estrogen. The commonly used measures include pH level, vaginal health index (VHI, Table 1) and the vaginal maturation index (VMI) [8]. Other tools used to assess treatment are a variety of questionnaires or scores, relying on patient's self-report, assessing symptoms' severity or quality of life parameters.…”

Section: Introductionmentioning

confidence: 99%

“…Other tools used to assess treatment are a variety of questionnaires or scores, relying on patient's self-report, assessing symptoms' severity or quality of life parameters. Available questionnaires include the Most Bothersome Symptoms (MBS), the Day-to-Day Impact on Vaginal Aging (DIVA) Questionnaire, the Vulvovaginal Symptoms Questionnaire (VSQ), and the Vulvar Pain Assessment Questionnaire (VPAQ) [8]. Alternatively, an array of scores rate severity of symptoms, enabling subjective comparison.…”

Section: Introductionmentioning

confidence: 99%

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“Modified Schirmer Test” as an Objective Measurement for Vaginal Dryness: A Prospective Cohort Study

et al. 2022

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None of the currently available parameters allow for a direct and objective measurement of vaginal moisture. We used a calibrated filter paper strip as a measurement tool for the quantification of vaginal fluid, in a similar manner as the ophthalmic “Schirmer test” (used for eye moisture measurement). The study aimed to evaluate the validity of this new, objective tool, to measure vaginal moisture. We compared vaginal moisture measurements using the “modified Schirmer test” in symptomatic women with genitourinary syndrome of menopause to those of women without vaginal dryness. The mean “modified Schirmer test” measurement in the control group was 21.7 mm compared to 3.3 mm in the study group, yielding a statistically significant difference (p < 0.001). Strong correlations were found between “modified Schirmer test” measurements and pH (correlation coefficient −0.714), Vaginal Health Index [VHI (0.775)], and Visual Analogue Score (VAS) of dryness during intercourse (−0.821). Our findings suggest that the “modified Schirmer test” can be used as an objective measurement for the assessment of vaginal fluid level. This test may also prove useful for evaluation of non-hormonal treatments aimed to treat vaginal dryness.

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“…Menopause is a gradual and physiological event due to ovarian failure and consequent hypoestrogenism, which significantly affects the lower genital tract. Several denominations are used to describe the alterations noticed in the lower genital tract, such as atrophic vaginitis, vulvovaginal atrophy (VVA), and, lately, genitourinary syndrome of menopause (GSM) (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Hormonal Approach for Postmenopausal Vulvovaginal Atrophy

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Vieira‐Baptista

et al. 2021

Front. Reprod. Health

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Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.

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Clinical manifestations and evaluation of postmenopausal vulvovaginal atrophy

Cited by 27 publications

References 53 publications

Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

“Modified Schirmer Test” as an Objective Measurement for Vaginal Dryness: A Prospective Cohort Study

Hormonal Approach for Postmenopausal Vulvovaginal Atrophy

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