title: Are women with urogenital atrophy symptomatic?
abstract: OBJECTIVE
  The purpose of this study was to determine the degree of correlation between physical signs of genital atrophy and symptoms that are suggestive of atrophic vaginitis.
  
  
  METHODS
  Female volunteers (n = 135; mean age, 69 years) rated the presence and severity (rating, 0-3) of vaginal atrophy symptoms. The presence and severity of vaginal mucosal changes, which included vaginal pH (0-3), were recorded during a pelvic examination. A vaginal cytologic maturation value was performed. Symptoms, signs, pH, and maturation value were correlated by the Spearman rank test.
  
  
  RESULTS
  Symptom scores were low (mean, 0.41; range, 0-2.6). Symptoms were only weakly correlated with physical findings (r = 0.14) and not with maturation value (r = 0.06) or age (r = -0.004). There was a moderate correlation between physical examination score and maturation value (r = -0.48). In women > or =65 years old, symptom score and physical examination score were correlated weakly (r = 0.25). Low pH correlated well with high maturation value (r = -0.52). Women who were undergoing estrogen therapy had higher symptoms scores (P =.0007) and maturation values (P =.0002) than women who were not undergoing therapy.
  
  
  CONCLUSIONS
  Although urogenital atrophy occurs universally after menopause, most elderly women are minimally symptomatic. Those women on estrogen replacement therapy may be more symptomatic. Symptoms alone should not be used as a guide for the initiation of estrogen therapy.
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston 33331, USA. davilag@ccf.org
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
authors.forename: Anita
authors.initials: A
authors.lastname: Singh
authors.forename: Ifigenia
authors.initials: I
authors.lastname: Karapanagiotou
authors.forename: Sherry
authors.initials: S
authors.lastname: Woodhouse
authors.forename: Karen
authors.initials: K
authors.lastname: Huber
authors.forename: Stephen
authors.initials: S
authors.lastname: Zimberg
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Seiler
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Kopka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001284:Atrophy; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D052776:Female Urogenital Diseases / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D012720:Severity of Illness Index; D014566:Urogenital System / Q000473:pathology*; D014621:Vagina / Q000473:pathology