The urinary tract is also commonly affected, leading to urinary frequency and urgency, nocturia, dysuria and incontinence. Recurrent urinary tract infections occur in up to 20% of postmenopausal women because of atrophy of the urothelium in response to estrogen deficiency.3
The Vaginal Health Index is commonly used by clinicians to rate both the appearance of the vaginal mucosa and production of secretions on a scale of 1–5. In 2014, the North American Menopause Society/International Society for the Study of Women’s Sexual Health Consensus Panel introduced the Genitourinary Syndrome of Menopause (GSM), an overarching terminology that describes various menopausal symptoms and signs including genital, sexual and urinary symptoms.
These seven components each receive a score from 0–3 based on severity of the condition. A total score is then calculated by adding each of the scores together to give a total out of 21. A score of 0–7 is considered to be mild atrophy, 7–14 moderate atrophy and >14 severe atrophy. The score system refers to the degree of atrophy rather than the ‘syndrome’ itself.3
2. Naumova, I. and Castelo-Branco, C. 2018 ‘Current treatment options for postmenopausal vaginal atrophy’, International Journal of Women’s Health. Volume 10, 387-395.
3. Khanjani, S. Panay, P. 2018 ‘Vaginal estrogen deficiency’, The Obstetrician & Gynaecologist. Volume 21, Issue 1, 37-42
4. Mac Bride, MB. et. al. 2010 ‘Vulvovaginal Atrophy’, Mayo Clinic Proceedings. Volume 85, Issue 1, 87-94