Abstract
None of the currently available parameters allow for a direct and objective measurement of vaginal moisture. We used a calibrated filter paper strip as a measurement tool for the quantification of vaginal fluid, in a similar manner as the ophthalmic “Schirmer test” (used for eye moisture measurement). The study aimed to evaluate the validity of this new, objective tool, to measure vaginal moisture. We compared vaginal moisture measurements using the “modified Schirmer test” in symptomatic women with genitourinary syndrome of menopause to those of women without vaginal dryness. The mean “modified Schirmer test” measurement in the control group was 21.7 mm compared to 3.3 mm in the study group, yielding a statistically significant difference (p < 0.001). Strong correlations were found between “modified Schirmer test” measurements and pH (correlation coefficient −0.714), Vaginal Health Index [VHI (0.775)], and Visual Analogue Score (VAS) of dryness during intercourse (−0.821). Our findings suggest that the “modified Schirmer test” can be used as an objective measurement for the assessment of vaginal fluid level. This test may also prove useful for evaluation of non-hormonal treatments aimed to treat vaginal dryness.
Highlights
Urogenital atrophy, referred to as genitourinary syndrome of menopause (GSM) [1], is caused by decreased estrogen levels in women’s urogenital tissues
Our findings suggest that the “modified Schirmer test” can be used as an objective measurement for the assessment of vaginal fluid level
Our goal was to evaluate the validity of this objective measurement tool for vaginal moisture by comparing measurements in symptomatic women suffering from GSMassociated vaginal dryness to measurements in healthy women without vaginal dryness
Summary
Urogenital atrophy, referred to as genitourinary syndrome of menopause (GSM) [1], is caused by decreased estrogen levels in women’s urogenital tissues. Symptoms include vulvovaginal discomfort described as dryness, itching, burning, irritation, and soreness; sexual dysfunction due to decreased lubrication and dyspareunia; and urinary complaints such as urgency, frequency, and recurrent urinary tract infections [2,3]. Prevalence of GSM is estimated at approximately 50–60%, making it one of the most frequent causes of genital complaints in this age group [4]. The diagnosis is clinical, based on a combination of symptoms and signs upon physical examination, including thin, pale, smooth, and shiny vaginal epithelium with diminished elasticity [2]. Estrogen supplementation (topically or systemically) is considered the most efficient treatment [5,6]. Epithelial maturation occurs, with subsequent changes in epithelial thickness, pH level, and tissue elasticity [6,7]
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