Genitourinary syndrome: pelvic examination contributes to optimal management in postmenopausal women

This cross-sectional study aimed to evaluate the correlation between self-reported symptoms, clinical assessment and vaginal hormonal cytology in diagnosing genital atrophy in postmenopausal women attending a tertiary menopause clinic.

A convenience sample of postmenopausal women aged 30 years and older, experiencing a broad spectrum of climacteric symptoms and without prior treatment or debilitating conditions, was included in the study. The study protocol encompassed: 1) Menopause Rating Scale (MRS), 2) pelvic examination using the Vaginal Health Index (VHI), and 3) assessment of vaginal hormonal cytology through the Meisels Index (MI). Univariate and bivariate descriptive analyses, as well as simple and multiple linear regression analyses, were conducted to identify factors associated with MI, with a significance level set at 5%.

One hundred and fifty-four women were studied, with a mean age of 50 years (±9) and mean age at menopause onset of 44.3 years (±6). The mean body mass index (BMI) was 28.7 (±5.4). The average MI was 47.8 (±23.8), MRS urogenital domain score was 6.1 (±3.7), and VHI score was 16.7 (±3.8). Multiple regression analysis showed significant associations between MI and total VHI (p < 0.001), BMI (p = 0.0263), and age (p = 0.0004). Women with higher MI tended to have higher VHI scores, higher BMI, and were younger.

The study suggests that pelvic examination contributes to optimal management of all postmenopausal women, including those who do not report symptoms.