Vaginal atrophy across the menopausal age: results from the ANGEL study

Objectives: This study aimed to investigate the prevalence of vaginal atrophy (VA) in women across the menopausal age. Methods: A multicenter cross-sectional investigation was performed on 747 females, 40–55 years of age, in 30 outpatient public services across the nation. The VA diagnosis was based on the combination of patient sensation of vaginal dryness, an objective sign of VA, and pH >5. Results: VA was diagnosed in 36.8% of women. Prevalence ranged from 19.2% (40–45 year olds) to 53.8% (52–55 year olds). pH >5 (37.5%) was less prevalent than isolated VA symptoms or signs. Vaginal dryness (64.0%) was the most prevalent symptom followed by dyspareunia (54.5%), itching (38.5%) burning (38.3%), and dysuria (28.9%). Prevalence of vaginal signs declined from vaginal dryness (60.3%) to vaginal thinning (54.5%), vaginal pallor (47.4%), presence of petecchiae (15.7%), and mucosa fragility (15.1%). Most signs and symptoms showed an age-related increase in frequency and intensity. VA was independently associated (R2 = 0.139; p < 0.0001) with age (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.03–1.13), being in postmenopause (OR 3.45; 95% CI 2.29–5.19), and presence of vasomotor symptoms (OR 3.10; 95% CI 2.09–4.60). Conclusion: VA and its symptoms are common in women across the menopausal age. VA identification may favor early management and treatment.