Assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy

The objective of this review is to provide an overview of existing and evolving methods of assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy A systematic literature search was carried out on MEDLINE and Embase in order to identify studies on diagnostic instruments for vulvar, vaginal, and lower urinary tract atrophy, as well as new possibilities allowing for an improved diagnostic future. Measurement of the most bothersome symptoms, especially dyspareunia and vaginal dryness, is possibly the most useful parameter in clinical practice, even though it is a subjective measurement. Regarding objective result measurements, the two main parameters to be studied are the vaginal maturation index and vaginal pH measurement. In addition, clinical exploration has value both with the vaginal health index and with the vulvar health index. Other research tools are arising, such as a broader knowledge of the vaginal lamina propria elements, the measurement of vaginal distension, and the possibilities of having vaginal tissue 'on a chip'. Gynecologists can make a diagnosis based on the patient's symptoms and a thorough physical examination. However, in cases in which you want to be sure of the diagnosis, and when you want to evaluate and compare treatment options, we need to assess the associated symptoms, vaginal maturation index, and vaginal pH with a clinical estimation by the physician. However, there is an increasing need for new objective parameters helping in the evaluation process.