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Predictors of impact of vaginal symptoms in postmenopausal women

Hunter, Mary M. MN1; Nakagawa, Sanae MA2; Van Den Eeden, Stephen K. PhD3; Kuppermann, Miriam PhD, MPH2; Huang, Alison J. MD2,4

doi: 10.1097/GME.0000000000000482
Original Articles
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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.

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.

Address correspondence to: Mary M. Hunter, MN, Department of Physiological Nursing, School of Nursing, University of California San Francisco, 2 Koret Way, Box 0610, San Francisco, CA 94143. E-mail: mary.hunter@ucsf.edu

Received 30 January, 2015

Revised 31 March, 2015

Accepted 31 March, 2015

Funding/support: This research was supported by grant 1R03AG035207 from the National Institute on Aging; grant P50 DK064538 from the National Institutes of Diabetes, Digestive, and Kidney Diseases and the Office of Research on Women's Health; a Paul Beeson Career Development Award in Aging Research; grant 1K23AG038335 from the National Institute on Aging and the American Federation on Aging Research; and the resources of Kaiser Permanente Northern California.

Financial disclosure/conflicts of interest: A.J.H. has received a grant from Pfizer Inc for unrelated research on vulvovaginal atrophy. S.K.V.D.E. has received grants from Takeda and Abbott Molecular for unrelated studies.

© 2016 by The North American Menopause Society.