Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy.
Palacios Institute of Women's Health, Madrid, Spain.
Menopause. 2019 May;26(5):485-491. doi: 10.1097/GME.0000000000001260.
This subanalysis of the European Vulvovaginal Epidemiology Survey study aimed to assess the correlation of vulvovaginal atrophy (VVA) symptoms and severity, when confirmed by objective gynecologic examination, with the quality of life of postmenopausal women.
Women aged 45 to 75 years with confirmation of last menstrual period more than 12 months before, who attended menopause or gynecology centers, were included. Those women had at least one VVA symptom filled in a group of questionnaires, including EuroQol-EQ-5D-3L and Day-to-Day Impact of Vaginal Aging (DIVA). To confirm the VVA diagnosis, an objective gynecologic examination was also performed.
Of a total of 2,160 evaluable women, 66.3%, 30.5%, and 11.2% suffered from severe vaginal, vulvar, and urinary symptoms, respectively. VVA was confirmed in more than 90% of the participants. Mean (±SD) EQ-5D-3L score was 0.892 ± 0.144 and mean (±SD) score on the associated visual analog scale was 71.7 ± 16.0. Mean (±SD) DIVA score was 0.922 ± 0.653. For both EQ-5D-3L and DIVA, the overall scores and most of the dimensions/components were statistically significantly worse for women with severe VVA symptoms (vulvar and urinary) compared with women not affected by severe symptoms. Quality of life questionnaires showed worse scores in women where the diagnosis of VVA was confirmed by gynecologic examination.
Severe VVA symptoms showed a direct association with worse quality of life in postmenopausal women. This important effect on the quality of life of many women should be recognized as equivalent to those from other conditions and pathologies of which there is greater awareness.
本项欧洲女性外阴阴道流行病学调查研究的亚分析旨在评估经客观妇科检查证实的外阴阴道萎缩（VVA）症状和严重程度与绝经后妇女生活质量的相关性。
纳入年龄在 45 岁至 75 岁之间、绝经前 12 个月以上有末次月经记录、就诊于绝经门诊或妇科中心的女性。这些女性在一组问卷中填写了至少一种 VVA 症状，包括 EuroQol-EQ-5D-3L 和每日阴道老化影响（DIVA）问卷。为了确认 VVA 诊断，还进行了客观的妇科检查。
在总共 2160 名可评估的女性中，分别有 66.3%、30.5%和 11.2%患有严重阴道、外阴和尿失禁症状。90%以上的参与者被证实患有 VVA。平均（±标准差）EQ-5D-3L 得分为 0.892±0.144，相关视觉模拟量表平均（±标准差）得分为 71.7±16.0。平均（±标准差）DIVA 得分为 0.922±0.653。对于 EQ-5D-3L 和 DIVA，患有严重 VVA 症状（外阴和尿失禁）的女性的总体评分和大多数维度/组成部分均明显差于未受严重症状影响的女性。VVA 诊断经妇科检查证实的女性生活质量问卷评分更差。
严重的 VVA 症状与绝经后妇女生活质量的下降直接相关。这种对许多女性生活质量的重要影响应被视为与其他疾病和病症同等重要，尽管后者得到了更多的认识。
