title: Predictors of impact of vaginal symptoms in postmenopausal women.
abstract: OBJECTIVE
  This study aims to identify factors associated with greater impact of vaginal symptoms on the functioning and well-being of postmenopausal women.
  
  
  METHODS
  Postmenopausal women who reported vaginal dryness, itching, irritation, or pain with sexual activity completed the multidimensional Day-to-day Impact of Vaginal Aging (DIVA) questionnaire and underwent assessment of multiple sociodemographic and clinical factors that have the potential to influence the impact of vaginal symptoms. Multivariable linear regression analyses examined relationships between selected participant characteristics and DIVA scale scores assessing symptom impact on activities of daily living, emotional well-being, self-concept and body image, and sexual functioning.
  
  
  RESULTS
  Among 745 symptomatic participants, the mean (SD) age was 56 (9) years, and 66% were racial/ethnic minorities. Women with comorbid depression reported greater impact of vaginal symptoms on all dimensions of functioning and well-being measured by the DIVA questionnaire (11%-22% estimated increase in impact scores associated with every three-point increase in Hospital and Anxiety Depression Scale scores). Women with urinary incontinence also reported greater impact of vaginal symptoms on activities of daily living, emotional well-being, and self-concept and body image (27%-37% estimated increase in impact scores). Age, partner status, frequency of sexual activity, general health, and body mass index also predicted greater impact on at least one domain.
  
  
  CONCLUSIONS
  Findings suggest that special efforts should be made to identify and treat vaginal symptoms in postmenopausal women known to have depression or urinary incontinence, as these women may experience greater impact of vaginal symptoms on multiple domains of functioning and quality of life.
authors.affiliation: 1Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA 2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 3Division of Research, Kaiser Permanente Northern California, Department of Urology, University of California San Francisco, San Francisco, CA 4Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Hunter
authors.forename: Sanae
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology; D001828:Body Image; D015992:Body Mass Index; D003863:Depression / Q000150:complications / Q000523:psychology; D004644:Emotions; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology / Q000523:psychology*; D011788:Quality of Life; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000523:psychology; D014623:Vaginal Diseases / Q000209:etiology / Q000473:pathology / Q000523:psychology*