Association of vaginal maturation index and vaginal ph with the most bothersome symptoms of genitourinary syndrome of menopause

Abstract

Introduction: Genitourinary syndrome of menopause (GSM) is a term used to characterize the symptoms and manifestations of estrogen deficiency in the female genitourinary tract. This syndrome has commnly occurred in postmenopause women yet often undertreatment due to lack of awareness either by physician or the patient herself. Aims and objectives: To assess the association between vaginal maturation index (VMI) and vaginal pH with the most bothersome symptoms of GSM. Methods: This was a cross-sectional study carried out from August to December 2020 in Medan, Sumatera Utara, Indonesia. A total of 150 postmenopause women who meet the criteria were recruited. This study data consisted of primary data of characteristic background, estradiol level, score of VMI, and vaginal pH. The subjects were divided into two groups regarding the existence of GSM related symptoms. The symptomatic women were asked for the most bothersome symptoms and analyzed based on its severity. Result: The majority of menopausal women (70.7%) did not report any GSM-related symptom. The most bothersome symptom (MBS) for this study is vaginal dryness and dyspareunia. The women with mild symptoms showed statistically higher vaginal pH and lower VMI compared to the subjects with moderate/severe symptoms (p <0.05). Conclusion: Lower VMI and higher vaginal pH associated with the severity of GSM symptoms.