M A Weber1, J Limpens, J P W R Roovers. 1. Department of Obstetrics and Gynecology, Academic Medical Center, H4.232, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands, m.a.weber@amc.uva.nl.
Abstract
INTRODUCTION AND HYPOTHESIS: The aim of this study is to provide an evidence-based definition of vaginal atrophy (VA) and present an overview of subjective and objective measurements of VA applicable in clinical practice and research. METHODS: A systematic literature search was performed in MEDLINE and EMBASE to identify studies reporting on measurement properties of diagnostic instruments for VA. Additional searches in MEDLINE aimed to document the definitions, diagnostic criteria, and outcome measures of VA. Studies reporting on definitions, diagnosis, outcome measurements, and measurement properties of diagnostic instruments of VA were selected. RESULTS: Specific symptoms for VA that were consistently described could be identified to suggest an evidence-based definition of VA. As subjective outcome measurements, seven scoring systems to assess the signs of VA during physical examination were identified. The most bothersome symptom (MBS) approach is most useful in clinical practice and research as it focuses on the most common symptoms of VA. As objective outcome measurements, numerous ways to assess vaginal cytology and vaginal pH were identified. CONCLUSIONS: At the moment, there is no consensus on the definition and assessment of VA. We propose to define VA as a common manifestation of estrogen decline associated with specific symptoms of which the most common are: vaginal dryness, itching or irritation, and dyspareunia. In both clinical and research settings, subjective assessment (the MBS approach) and objective assessments of VA (measurement of vaginal maturation index and vaginal pH) should be combined.
INTRODUCTION AND HYPOTHESIS: The aim of this study is to provide an evidence-based definition of vaginal atrophy (VA) and present an overview of subjective and objective measurements of VA applicable in clinical practice and research. METHODS: A systematic literature search was performed in MEDLINE and EMBASE to identify studies reporting on measurement properties of diagnostic instruments for VA. Additional searches in MEDLINE aimed to document the definitions, diagnostic criteria, and outcome measures of VA. Studies reporting on definitions, diagnosis, outcome measurements, and measurement properties of diagnostic instruments of VA were selected. RESULTS: Specific symptoms for VA that were consistently described could be identified to suggest an evidence-based definition of VA. As subjective outcome measurements, seven scoring systems to assess the signs of VA during physical examination were identified. The most bothersome symptom (MBS) approach is most useful in clinical practice and research as it focuses on the most common symptoms of VA. As objective outcome measurements, numerous ways to assess vaginal cytology and vaginal pH were identified. CONCLUSIONS: At the moment, there is no consensus on the definition and assessment of VA. We propose to define VA as a common manifestation of estrogen decline associated with specific symptoms of which the most common are: vaginal dryness, itching or irritation, and dyspareunia. In both clinical and research settings, subjective assessment (the MBS approach) and objective assessments of VA (measurement of vaginal maturation index and vaginal pH) should be combined.
Authors: E Weisberg; R Ayton; G Darling; E Farrell; A Murkies; S O'Neill; Y Kirkegard; I S Fraser Journal: Climacteric Date: 2005-03 Impact factor: 3.005
Authors: James A Simon; Celine Bouchard; Arthur Waldbaum; Wulf Utian; Joanne Zborowski; Michael C Snabes Journal: Obstet Gynecol Date: 2007-03 Impact factor: 7.661
Authors: Jeanne Carter; Cara Stabile; Barbara Seidel; Raymond E Baser; Shari Goldfarb; Deborah J Goldfrank Journal: J Cancer Surviv Date: 2016-11-21 Impact factor: 4.442
Authors: Jana D Illston; Thomas L Wheeler; C Richard Parker; Michael G Conner; Kathryn L Burgio; Patricia S Goode; Holly E Richter Journal: Maturitas Date: 2015-06-05 Impact factor: 4.342
Authors: Fiona G Li; Sarah Maheux-Lacroix; Rebecca Deans; Erin Nesbitt-Hawes; Aaron Budden; Kimberly Nguyen; Claire Y Lim; Sophia Song; Lalla McCormack; Stephen D Lyons; Eva Segelov; Jason A Abbott Journal: JAMA Date: 2021-10-12 Impact factor: 56.272
Authors: Debra L Barton; Lynne T Shuster; Travis Dockter; Pamela J Atherton; Jacqueline Thielen; Stephen N Birrell; Richa Sood; Patricia Griffin; Shelby A Terstriep; Bassam Mattar; Jacqueline M Lafky; Charles L Loprinzi Journal: Support Care Cancer Date: 2017-11-21 Impact factor: 3.603
Authors: David D Rahn; Holly E Richter; Vivian W Sung; Wilma I Larsen; Linda S Hynan Journal: Female Pelvic Med Reconstr Surg Date: 2021-01-01 Impact factor: 1.913