Gynaecological history, complaints and examinations in a middle-aged population

A sample of women aged 40-56 years (n = 1349) was selected at random from the Census Register of Göteborg, Sweden. Altogether, 1095 (81%) filled out a questionnaire concerning gynaecological data. A control group (n = 170) was established and 135 women from this group (79%) underwent an extensive personal interview and pelvic examination. One aim was to investigate the representativity of the control group for the initial random sample and to compare the information obtained from the questionnaire with the information acquired by personal interview. An additional aim was to obtain information related to pelvic examination and FSH concentrations in the serum of middle-aged women. In general there was a good agreement between information from questionnaires and from personal interviews. The pelvic examination revealed that 53% of the post-menopausal women showed signs of genital atrophy and this condition was more common in sexually inactive than active women. Weakness of the pelvic floor was encountered in 16%. The uterus was of normal size in 94%, anteflexed in 76%, mid-positioned in 8% and retroflexed in 16%. There was a positive correlation between a pathological smear and cervical ectopy. Serum FSH values in menstruating women ranged from 6.4 to 47 IU/l. A cut-off value of 50 IU/l gave a complete separation between menstruating and post-menopausal subjects.