CASE REPORT   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 December;177(12):741-4

DOI: 10.23736/S0393-3660.18.03686-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Vaginal health index score and urogenital syndrome of menopause

Raffaela DI PACE ✉, Rosalba PORTUESI

Department of Preventive Gynecology, European Istitute of Oncology, Milan, Italy

The average age for menopause is 50, while the average lifespan is over 80 years, therefore, a woman spends one third of her life in a condition which involves lacking estrogen. Vulvovaginal atrophy affects about 60% of women in their postmenopausal state. Furthermore, more than half of women who report having vulvovaginal atrophy and dyspareunia do not realize that this problem, if not treated, will not be solved by itself, but will tend to only worsen. In 2014, the definition of vulvovaginal atrophy was reclassified with the new terminology of menopausal genitourinary syndrome (GSM). This new definition refers to the combination of symptoms and signs associated with the reduction of estrogen and other sexual steroids and includes changes of the labia minora, clitoris, vulval vestibule, vagina, urethra and bladder. Nevertheless, it is difficult to objectify and to standardize the definition of the clinical picture. Thus many doctors carry out a diagnosis of vulvovaginal atrophy during their daily practice according to their clinical judgement, symptoms and general clinical condition of patients or visual inspection. We will look for a new visual and clinical method to evaluate vulvovaginal atrophy in an objective and reproducible way using Vaginal Health Index Score with many imagines to leave an example for all Gynecologists. The Vaginal Health Index Score is a tool that, by evaluating 5 parameters (vaginal elasticity, vaginal secretions, pH, epithelial mucous membrane, vaginal hydration), allows us to obtain a final score defining the degree of atrophy in the genitourinary tract by assigning a single score to each parameter. We consider 5 patients with different degree of GSM and produced photos of their genitalia to demonstrate how easy using the score can be. This type of assessment should be able to eliminate the marginal subjectivity that each exam can involve. Surely, the habit of using VHI removes intra-operator variability, as you get used to standardizing your judgement.

KEY WORDS: Vulva - Vagina - Muscular atrophy - Dyspareunia - Urogenital abnormalities