Vaginal dryness: individualised patient profiles, risks and mitigating measures
Vaginal dryness (VD) affects both pre- and postmenopausal women at any age. Since the hormonal regulation changes during the climacteric period are considered as being the main course of the VD, affected women prefer not to talk about the problem. However, the problem does exist, and unfortunately if any, relatively minor group in the population possesses the health literacy at sufficient level to understand that VD is a suboptimal health condition which carries a multi-factorial character. Thereby, some of the contributing factors are clearly preventable and, therefore, if treated properly, have a potential to milden the VD. Current chapter demonstrates specific signs and symptoms of Flammer syndrome in women suffering from vaginal dryness, although individualised patient profiles clearly discriminate between pre- and postmenopausal women regarding the subgroup-specific symptoms. Noteworthy, about 20% of the VD patients involved in the study notify a delayed or even impaired wound healing observed for themselves over a couple of years.
Optimising modifiable risk factors accompanying FS phenotype at the level of primary prevention is strongly recommended. Individualised patient profiles provide important information for VD mitigating measures tailored to the person. Further, future projects should essentially deal with the complexity of vulvar-vaginal dryness as part of the Sicca syndrome in individuals with FS phenotype, in order to prevent genital female cancers which may occur at any age. In contrast to the human papilloma virus as possible trigger of the disease, the role of the vulvar-vaginal dryness as an important risk factor is strongly underestimated in currently applied diagnostic and treatment approaches.
KeywordsVaginal dryness Vaginal dysfunction Vasoconstriction Dehydration Sicca Stress Altered sense regulation Blood pressure Menopause Hormonal regulation Microbiome Pain Sexual intercourse Headache Psychological aspects Life quality Dyspareunia Vulva cancer Flammer syndrome
Olga Golubnitschaja is the coordinator of the international project, who has created the main scientific concepts and hypotheses presented in the article; she has drafted the manuscript. Vadym Goncharenko and Rostyslav Bubnov have coordinated the research, patient recruitment, data analysis and interpretation performed in Ukraine. Pavol Zubor has coordinated the research, patient recruitment, data analysis and interpretation performed in Slovakia. Jiri Polivka Jr. has performed data evaluation and statistical analysis. Walther Kuhn, Kamil Biringer and Tibor Bielik have contributed to the project by conceptual development of the publication. All the authors have read and approved the final manuscript.
This multi-centre study has been supported by the following organisations: European Association for Predictive, Preventive and Personalised Medicine, EPMA, Brussels, Belgium; Centre of excellence for perinatology research II co-financed from EU sources (ITMS: 26220120036), Slovak Republic; and the National Sustainability Program I (NPU I) Nr. LO1503, Ministry of Education Youth and Sports, Czech Republic and MH CZ-DRO (Faculty Hospital in Plzen-FNPl, 00669806).
Compliance with ethical standards
All procedures performed in the current study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study-relevant ethical committees have approved the approach and involvement of the local patients into the international multi-centre study, namely in Ukraine—Bogomolets National Medical University/Clinical Hospital “Pheophania”, Kyiv, Ukraine (protocol number 85, issued 11.02.2015) by the ethics committee of institutional review board and Special Academic Council on Doctoral Thesis of D.K. Zabolotny Institute of Microbiology and Virology of the National Academy of Sciences of Ukraine (protocol N 7 issued 03.07.2018), and in Slovak Republic—Department of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Martin University Hospital, Martin, (protocol number IRB 1927/2016).
The authors declare that they have no competing interests.
Informed consent statement
All subjects, who have been involved in the study, agreed to participate and signed the “informed consent” form.
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