Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 13 , ISSUE 5 ( September-October, 2021 ) > List of Articles


Association of Vaginal Maturation Index and Vaginal pH with the Most Bothersome Symptoms of Genitourinary Syndrome of Menopause

Irwin L Lumbanraja, Muhammad FG Siregar, Sarma N Lumbanraja, Ichwanul Adenin, Letta Sari Lintang, Binarwan Halim

Keywords : Genitourinary syndrome of menopause, Menopause, Vaginal cytology, Vaginal maturation index

Citation Information : Lumbanraja IL, Siregar MF, Lumbanraja SN, Adenin I, Lintang LS, Halim B. Association of Vaginal Maturation Index and Vaginal pH with the Most Bothersome Symptoms of Genitourinary Syndrome of Menopause. J South Asian Feder Obs Gynae 2021; 13 (5):288-291.

DOI: 10.5005/jp-journals-10006-1950

License: CC BY-NC 4.0

Published Online: 22-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


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.

PDF Share
  1. Dutton PJ, Rymer, JM. Physiology of the menstrual cycle and changes in the perimenopause. In: Managing the menopause: 21st century solutions; 2015.
  2. Portman DJ, Gass ML; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Menopause 2014;21(10):1063–1068. DOI: 10.1097/GME.0000000000000329.
  3. Palma F, Volpe A, Villa P, et al. Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: the AGATA study. Maturitas 2016;83:40–44. DOI: 10.1016/j.maturitas.2015.09.001.
  4. Kingsberg SA, Krychman M, Graham S, et al. The Women's EMPOWER Survey: identifying women's perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med 2017;14(3):413–424. DOI: 10.1016/j.jsxm.2017.01.010.
  5. Takahashi TA, Johnson KM. Menopause. Med Clin North Am 2015;99(3):521–534. DOI: 10.1016/j.mcna.2015.01.006.
  6. Weber MA. Effects of vaginal prolapse surgery and ageing on vaginal vascularization. Universiteit van Amsterdam [Host]; 2016.
  7. Ettinger B, Hait H, Reape KZ, et al. Measuring symptom relief in studies of vaginal and vulvar atrophy: the most bothersome symptom approach. Menopause 2008;15(5):885–889. DOI: 10.1097/gme.0b013e318182f84b.
  8. Kagan R, Kellogg-Spadt S, Parish SJ. Practical treatment considerations in the management of genitourinary syndrome of menopause. Drugs Aging 2019;36(10):897–908. DOI: 10.1007/s40266-019-00700-w.
  9. Gebhart JB, Rickard DJ, Barrett TJ, et al. Expression of estrogen receptor isoforms alpha and beta messenger RNA in vaginal tissue of premenopausal and postmenopausal women. Am J Obstet Gynecol 2001;185(6):1325–1330. DOI: 10.1067/mob.2001.119627.
  10. Tan O, Bradshaw K, Carr BR. Management of vulvovaginal atrophy related sexual dysfunction in postmenopausal women: an up-to-date review. Menopause 2012;19(1):109–117. DOI: 10.1097/gme.0b013e31821f92df.
  11. Nappi RE, Martini E, Cucinella L, et al. Addressing vulvovaginal atrophy (VVA)/genitourinary syndrome of menopause (GSM) for healthy aging women. Front Endocrinol (Lausanne) 2019;10:561. DOI: 10.3389/fendo.2019.00561.
  12. Simon JA, Kokot-Kierepa M, Goldstein J, et al. Vaginal health in the United States: results from the vaginal health: insights, views & attitudes survey. Menopause 2013;20(10):1043–1048. DOI: 10.1097/GME.0b013e318287342d.
  13. Gorodeski GI. Estrogen modulation of epithelial permeability in cervical-vaginal cells of premenopausal and postmenopausal women. Menopause 2007;14(6):1012–1019. DOI: 10.1097/gme. 0b013e3180587eb5.
  14. Griebling TL, Liao Z, Smith PG. Systemic and topical hormone therapies reduce vaginal innervation density in postmenopausal women. Menopause 2012;19(6):630–635. DOI: 10.1097/gme. 0b013e31823b8983.
  15. Bachmann GA, Cheng RJ, Rovner E. Vulvovaginal complaints. In: Lobo RA, editor. Treatment of the postmenopausal woman: basic and clinical aspects, 3rd ed. Burlington, MA: Academic Press; 2007. p. 263–270.
  16. Fisher BK. Normal anatomy of the vulva. In: Fisher BK, Margesson LJ, editors. Genital skin disorders: diagnosis and treatment. St Louis, MO: Mosby; 1998. p. 99–107.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.