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best course of treatment. For those who have symptoms related to sexual activities, a lubricant may be sufficient. If both urinary and genital symptoms exist, local, low-dose estrogen therapy can be effective. Those individuals who are survivors of hormone-sensitive cancer may need to be treated more cautiously. Some people can have symptoms that are widespread and may be at risk for osteoporosis. Estrogen and adjuvants may be best. Recent research showed a medication called ospemifene can be an alternative oral treatment if vaginal products or hormone therapy is not suitable for patients surviving gynecological cancer. Ospemifene can increase collagen production to improve vaginal tissue, which will help reduce GSM symptoms. Studies have shown this medication has helped increase vaginal pH, elasticity, and moisture to improve vaginal health as well as sexual and emotional well-being.
309:
Estrogen helps maintain a thick, glycogen-rich vaginal lining, which healthy bacteria use to produce lactic acid to keep the vaginal environment acidic, reducing infection risks. In premenopausal women, the main form of estrogen is called estradiol and fluctuates between 40 and 200 pg/mL, rising to 600 pg/mL during ovulation. Postmenopause, estrogen levels drop significantly tp 5-18 pg/mL, leading to gradual changes in the urogenital area. All tissue types such as connective, epithelial, muscular, blood vessels, and nerves are affected and become thinner and less effective, which increases risk of infections, inflammation, injuries, and sores. Blood flow and sensation can decrease, causing pain during sex and the pH level can rise due to decreased lactic acid production, which can allow harmful bacteria and fungi to grow and cause infections.
605:
requirements for inclusion criteria. One of the trials showed that there was a significant impact in helping alleviate GSM symptoms with using 1 mg vitamin E in the experimental group compared to the placebo group. Another trial showed 5 mg vaginal hyaluronic acid had a greater impact than 1 mg vitamin E. Two of the other trials showed there were no difference between using 0.5 g vaginal estrogen and 100 IU of vaginal vitamin E. Since the authors were only able to use four studies, they encountered some limitations such as using a small number of studies and not having as much evidence. In conclusion, the review article found that vaginal vitamin E can be used to helping with GSM symptom but further studies need to be conducted to confirm its efficacy and safety.
514:
improvement in their sex life. If a person cannot tolerate or use estrogen therapy, topical hyaluronic acid can be used as another option which has been shown to be safe and effective. For mild atrophic vaginitis, hyaluronic acid can be used as a treatment first. However, if it is moderate to severe atrophic vaginitis, estrogen therapy is recommended to be used first. Vitamin E vaginal suppositories were also found to be helpful in relieving symptoms of GSM, but further studies need to be done to evaluate how safe and effective this treatment is for this condition. Other studies have discussed using vaginal oxytocin as a treatment, but there has been no significant effect on GSM in either helping alleviate signs and symptoms or improving the condition.
476:
such as before the first menstural cycle, during reproductive years, and after menopause, the distribution of these cell types changes. VMI is determined using a specific formula and provides a more comprehensive view of the hormonal effects on the vagina over time than a single hormone level measurement. VMI is particularly useful in clinical research for evaluating the impact of hormone therapy and changes in sexual function during menopause. VMI is also a better measure of vaginal atrophy than patient-reported symptoms of vaginal dryness.
50:
585:. In a 2021 systematic review, fractionated type CO2 laser therapy used for GSM was shown to be effective and safe in the studies the researchers reviewed. However, there is a lot of evidence still needed to determined how effective this therapy is compared to other treatments for GSM such as hormonal, non-hormonal, and topical treatments. In addition, further studies conducted can also help determine which groups of patients would benefit from CO2 laser therapy.
597:
week, both treatments significantly improved symptoms, including vaginal health index (VHI), maturity valve (MV), and overall symptoms of vaginal atrophy. The Aloe Vera group showed a notable increase in superficial cells and superior results in fluid volume compared to the estrogen group. The study concluded that Aloe Vera cream is as effective as estrogen cream, presenting a viable alternative for women who cannot use estrogen therapy.
593:
group, which received conjugated estrogen vaginal cream. The study measured clinical signs and the
Vaginal Maturation Index (VMI). The results indicated that while fenugreek extract showed some efficacy in treating atrophic vaginitis, it was significantly less effective that ultra-low-dose estrogen as evidenced by higher VMI scores and greater improvement in clinical signs in the control group.
301:
levels drop, this process slows down, leading to thinner vaginal tissue, less moisture, and a less acidic environment. As a result, there's a higher risk of getting vaginal and urinary tract infections. Normal menopause and treatments such as chemotherapy or medications may result in loss of estrogen.
600:
A 2021 systematic review studied the use of hyaluronic acid for those with postmenopausal vaginal atrophy. From the 833 studies identified, the comparisons of hyaluronic acid to vaginal estrogen treatments appear to have similar safety, tolerability, and efficacy based on outcomes such as vaginal pH
596:
A 2021 study examined the effectiveness of aloe vera vaginal cream for the treatment of atrophic vaginitis. This randomized, double-blind, controlled trial compared the effectiveness of Aloe Vera vaginal cream to estrogen vaginal cream in treating vaginal atrophy in 60 postmenopausal women. Over six
522:
Atrophic vaginitis develops in 10-50% of postmenopausal women. Of those who are postmenopausal and have developed atrophic vaginitis, 50-70% develop symptoms. Around 30% of women with atrophic vaginitis discuss their symptoms with their primary healthcare provider. It is likely to be under diagnosed
475:
The
Vaginal Maturation Index (VMI) is a measure used to assess the composition of different types of cells in the vaginal lining. It helps to evaluate the hormonal environment in the vagina by calculating the proportion of different types of cells present in the vagina. During different life stages,
462:
will change from being acidic to a more neutral pH at around 4.5 or higher. This is typically taken by placing Litmus test strip on the wall of the vagina. Papillary and reticular, as well as skin and dermal tissue atrophy are observed via histological examinations. Observed reduced vascularization,
592:
A 12-week randomized controlled clinical trial conducted in
Ardabil, Iran, in 2018 evaluated the effectiveness of fenugreek extract on atrophic vaginitis in 60 postmenopausal women. Research participants were dividied into an intervention group, which received fenugreek vaginal cream, and a control
308:
may be at a higher risk of developing atrophic vaginitis due to chemotherapy and other endocrine treatments. Estrogen is crucial for women's sexual and urinary health. It supports the tissues in the lower vagina and urinary tracts to keep them thick, elastic, and mosit and ensuring good blood flow.
604:
A 2022 systematic review evaluated randomized controlled trials to see if there were evidence to support the effectiveness of using vaginal
Vitamin E and whether it helped alleviate GSM symptoms in postmenopausal individuals. The authors looked into 31 studies and found four of the studies met the
488:
Topical treatment with estrogen is effective when the symptoms are severe and relieves the disruption in pH to restore the microbiome of the vagina. When symptoms include those related to the urinary system, systematic treatment can be used. Recommendations for the use of the lowest effective dose
412:
It can be challenging to diagnose atrophic vaginitis given that the symptoms are mild and nonspecific for many postmenopausal women. Since women can have signs and symptoms that could be attributed to other causes, diagnosis is based upon the symptoms that cannot be better accounted for by another
300:
Atrophic vaginitis may be caused by tissue thinning, loss of elasticity, and loss of vaginal fluids from low estrogen levels. Normally, estrogen helps the vagina shed old cells, which are then converted into lactic acid by good bacteria. This keeps the vagina's pH acidic and healthy. When estrogen
588:
In addition, there were several studies that looked into whether vaginal oxytocin was an alternative hormone treatment for atrophic vaginitis. In 2023, a systematic review found that there was no significant effect using vaginal oxytocin for this condition. The article explored vaginal maturation
493:
applied to the vagina. The use of estrogen for treatment do come at some risk. Those who are treated with estrogen may be at a higher risk of developing vaginal candidiasis since estrogen allows lactobacilli to increase in levels. Additionally, it is recommended that soaps and other irritants are
484:
Symptoms of genitourinary syndrome of menopause (GSM) will unlikely be resolved without treatment. Some individuals may have many or a few symptoms so treatment is provided that best suits each person. If other health problems are also present, these can be taken into account when determining the
543:
suggests that the vagina is inflamed or infected. Though this may be true, inflammation and infection are not the major components of postmenopausal changes to the vagina. The former terms do not describe the negative effects on the lower urinary tract which can be the most troubling symptoms of
513:
may be helpful. Since GSM may also cause urinary problems related to pelvic floor dysfunction, the person may benefit from pelvic floor strengthening exercises. The individual and their partners have reported that estrogen therapy resulted in less painful sex, more satisfaction with sex, and an
589:
index, vaginal pH, endometrial thickness, and dyspareunia. Even though there were lack of evidence to support using vaginal oxytocin for atrophic vaginitis, further studies should be conducted to gain a better understanding of oxytocin's effects and its efficacy on this condition.
336:
changes and becomes a few layers thick. Many of the signs and symptoms that accompany menopause occur in atrophic vaginitis. The earliest symptoms of atrophic vaginitis may be decreased vaginal lubrication, while other symptoms may appear later. Genitourinary symptoms include
523:
and under treated due to lack of awareness of those who are affected by atrophic vaginitis and of healthcare providers. Symptoms of genitourinary syndrome of menopause (GSM) are seen in 65% women one year post-menopause versus 87% six years post-menopause.
463:
atrophy of epithelial tissue leading to reduced thickness, and paleness are all apparent in post-menopausal women during histological examinations. Microscopy laboratory tests may be used to rule out symptoms caused by trichomoniasis and other bacteria. A
283:: Chemotherapy, selective estrogen receptor modulators (e.g. Tamoxifen and Raloxifene), or aromatase inhibitors (e.g. Letrozole, Anastrozole, and Exemestane) can lead to decreased estrogen levels and therefore side effects that include atrophic vaginitis.
437:
Lab tests usually do not provide information that will aid in diagnosing. A visual exam is useful. The observations of the following may indicate lower estrogen levels: little pubic hair, loss of the labial fat pad, thinning and resorption of the
442:, and the narrowing of the vaginal opening. An internal exam will reveal the presence of low vaginal muscle tone, the lining of the vagina appears smooth, shiny, pale with loss of folds. The cervical fornices may have disappeared and the
429:, candidiasis, and contact irritation from irritants such as soaps, pantyliners, or tight-fitting clothing. For example, a person who does not feel itching is unlikely to have candidiasis and no odor likely rules out bacterial vaginosis.
243:
In a majority of postmenopausal women, there are risk factors that can contribute to atrophic vaginitis. Specifically, these risk factors are directly related to decreased estrogen levels and vaginal health. Some risk factors include
1570:
Portman DJ, Gass ML (November 2014). "Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the
International Society for the Study of Women's Sexual Health and the North American Menopause Society".
576:
In 2018, the FDA issued a warning that lasers and other high energy devices were not approved for "rejuvenating" the vagina, and it has received many reports of injuries. Such devices are scams and have been shown to only cause
538:
have been the preferred terms for this condition and cluster of symptoms until recently. These terms are now regarded as inaccurate in describing changes to the entire genitourinary system occurring after menopause. The term
234:
Treatment for atrophic vaginitis may involve the use of topical estrogen or other estrogen replacement. To treat the symptoms, patients may use lubricants, but it may not help long term as it does not affect the tissues.
216:. Atrophic vaginitis as well as vulvovaginal atrophy, bladder and urethral dysfunctions are a group of conditions that constitute genitourinary syndrome of menopause (GSM). Diagnosis is typically based on symptoms.
2486:
2471:
1522:
Knörr K, Knörr-Gärtner H, Beller FK, Lauritzen C (2013). "Funktionelle
Anatomie und Histologie der weiblichen Genitalorgane" [Functional anatomy and histology of the female genital organs].
568:. Overall, the current preferred term is Genitourinary syndrome of Menopause (GSM). It is an umbrella term for vulvovaginal atrophy, atrophic vaginitis, urogenital atrophy and vaginal atrophy.
2323:
Safary M, Hakimi S, Mobaraki-Asl N, Amiri P, Tvassoli H, Delazar A (2020-10-27). "Comparison of the
Effects of Fenugreek Vaginal Cream and Ultra Low- Dose Estrogen on Atrophic Vaginitis".
2586:
265:: These treatments involve radiation or embolization of the ovaries and can cause ovarian damage. This leads to decreased estrogen production and symptoms of atrophic vaginitis.
3408:
2579:
324:. Additional risk factors include smokers, those who have not given birth naturally (through the vagina), and increased prolactin levels while lactation.
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2034:"Comparison of the Efficacy of Vaginal Hyaluronic Acid to Estrogen for the Treatment of Vaginal Atrophy in Postmenopausal Women: A Systematic Review"
2257:
2230:
421:
To determine if atrophic vaginitis is the cause for a patient's symptoms, differential diagnosis may be used. Other diagnosis include
268:
Hypothalamic-Pituitary
Disorders: These disorders directly affect the hypothalamus or pituitary gland, disrupting hormone production.
1982:"The effects of various therapies on vulvovaginal atrophy and quality of life in gynecological cancer patients: a systematic review"
1898:"Vaginal maturation index self-sample collection in mid-life women: acceptability and correlation with physician-collected samples"
2088:"Vaginal Vitamin E for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials"
1535:
498:
2140:"The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis"
467:, also known as a pap test, would not be useful as it does not correlate strongly with the symptoms of atrophic vaginitis.
1477:"Practical Aspects in the Management of Vaginal Atrophy and Sexual Dysfunction in Perimenopausal and Postmenopausal Women"
3373:
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and cell maturation. Thus, hyaluronic acid may be a suitable treatment for those who cannot tolerate hormonal treatment.
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All of these factors impact estrogen levels and vaginal health, causing an increase in
Atrophic vaginitis development.
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Antiestrogen medications may also contribute to the development of atrophic vaginitis. These medications include
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Vulvovaginal atrophy, vaginal atrophy, genitourinary syndrome of menopause, estrogen deficient vaginitis
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by two professional societies. The term atrophic vaginitis does not reflect the related changes of the
252:: Women who undergo surgical removal of both ovaries, potentially causing a decline in estrogen levels.
189:
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509:. Other treatments are available without a prescription such as vaginal lubricants and moisturizers.
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2694:
2501:
2358:
Poordast T, Ghaedian L, Ghaedian L, Najib FS, Alipour S, Hosseinzadeh M, et al. (2021-04-24).
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for the shortest duration help to prevent adverse endometrial effects. Treatment is generally with
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1476:
258:: Ovaries fail to properly function before 40 years of age, causing a decrease in estrogen levels.
3242:
3192:
3148:
2806:
2360:"Aloe Vera; A new treatment for atrophic vaginitis, A randomized double-blinded controlled trial"
987:"Long-term health consequences of premature or early menopause and considerations for management"
92:
87:
277:
Postpartum
Breastfeeding: Breastfeeding can cause lower estrogen levels due to hormonal changes.
3403:
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502:
209:
145:
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2138:
Farahat RA, Salamah HM, Mahmoud A, Hamouda E, Hashemy M, Hamouda H, et al. (2023-09-16).
621:
International Society for the Study of Women's Sexual Health and the Board of Trustees of The
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169:
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Dos Santos CC, Uggioni ML, Colonetti T, Colonetti L, Grande AJ, Da Rosa MI (January 2021).
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150:
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Medeiros AG, Cintra MM, dos Reis MA, Rocha LP, do Carmo Neto JR, Machado JR (2024-06-19).
8:
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450:. Inflammation is apparent when the vaginal lining bleeds easily and appears swollen.
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212:. It generally does not resolve without ongoing treatment. Complications may include
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1667:
Angelou K, Grigoriadis T, Diakosavvas M, Zacharakis D, Athanasiou S (April 2020).
1002:
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2517:
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1997:
1384:
1271:"Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue"
1182:
1134:
1102:
953:
906:
853:"Atrophic vaginitis in breast cancer survivors: a difficult survivorship issue"
506:
426:
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1949:
705:"Genitourinary Syndrome of Menopause: Management Strategies for the Clinician"
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1921:
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2013:
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888:
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271:
249:
2258:"The FDA needs to take another look at laser-based 'vaginal rejuvenation'"
2086:
Porterfield L, Wur N, Delgado ZS, Syed F, Song A, Weller SC (April 2022).
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2050:
1669:"The Genitourinary Syndrome of Menopause: An Overview of the Recent Data"
1524:
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2407:"Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review"
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67:
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274:: Medications such as Danazol or Leuprolide can lower estrogen levels.
3257:
3247:
3133:
2603:
2523:
2277:"Carbon Dioxide Laser Vulvovaginal Rejuvenation: A Systematic Review"
317:
220:
123:
1530:] (in German) (3rd ed.). Berlin: Springer. pp. 24–25.
3363:
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1528:
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578:
557:
464:
197:
111:
2528:
1521:
1167:"Hormonal treatments for endometriosis: The endocrine background"
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Some treatments have been developed more recently. These include
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228:
193:
1164:
3004:
2775:
2475:
447:
443:
2594:
1044:"Current treatment options for postmenopausal vaginal atrophy"
801:"The Recent Review of the Genitourinary Syndrome of Menopause"
2357:
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1607:"What causes a woman to bleed after sex? - Health questions"
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57:
Normal vaginal mucosa (left) versus vaginal atrophy (right)
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851:
Lester J, Pahouja G, Andersen B, Lustberg M (March 2015).
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898:
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or using specific medications. Risk factors include
219:
The decrease in estrogen typically occurs following
985:Faubion SS, Kuhle CL, Shuster LT, Rocca WA (2015).
2231:"FDA warning shines light on vaginal rejuvenation"
1474:
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3409:Noninflammatory disorders of female genital tract
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703:Faubion SS, Sood R, Kapoor E (December 2017).
548:(GSM) was determined to be more accurate than
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2131:
1630:
1427:
1382:
951:
846:
844:
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904:
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416:
1837:
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1740:
1475:Goldstein I, Alexander JL (2005-09-01).
1321:
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204:, vaginal itchiness or dryness, and an
14:
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773:
737:
499:selective estrogen receptor modulators
385:increased susceptibility to infections
2617:
2568:
2228:
2081:
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2027:
2025:
2023:
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1421:
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1417:
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446:can appear flush with the top of the
362:malodorous discharge due to infection
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261:Ovarian Failure due to Radiation or
3374:Persistent genital arousal disorder
1718:Hainer BL, Gibson MV (2011-04-01).
546:Genitourinary syndrome of menopause
24:
2351:
2076:
2020:
1968:
1878:
1828:
1624:
1446:10.1097/01.NPR.0000391175.25008.ae
1408:
1369:
453:
25:
3425:
3188:Hypoactive sexual desire disorder
2707:Ovarian hyperstimulation syndrome
2449:
2337:10.2174/1567201817666200708112655
1741:Hum M, Dytoc M (September 2017).
930:
1493:10.1111/j.1743-6109.2005.00131.x
1275:Journal of Personalized Medicine
1224:"Lactational atrophic vaginitis"
857:Journal of Personalized Medicine
623:North American Menopause Society
2398:
2268:
2249:
2222:
2190:
1806:10.1016/j.maturitas.2009.04.009
1781:
1734:
1711:
1599:
1585:10.1016/j.maturitas.2014.07.013
1468:
1262:
1215:
1158:
1126:
1103:"Primary Ovarian Insufficiency"
615:
517:
304:Those with or had a history of
238:
179:Half of women (after menopause)
2802:Dysfunctional uterine bleeding
2411:The Journal of Sexual Medicine
2092:Journal of Menopausal Medicine
1481:The Journal of Sexual Medicine
1101:Sopiarz N, Sparzak PB (2024),
1094:
1035:
978:
805:Journal of Menopausal Medicine
526:
471:Vaginal Maturation Index (VMI)
13:
1:
1790:"Managing urogenital atrophy"
1240:10.1016/s1526-9523(03)00143-0
1003:10.3109/13697137.2015.1020484
632:
388:decreased vaginal lubrication
256:Primary Ovarian Insufficiency
200:levels. Symptoms may include
2898:Menorrhagia (hypermenorrhea)
2869:Polymenorrhea (epimenorrhea)
2364:Journal of Ethnopharmacology
2197:Bleibel B, Nguyen H (2024),
1914:10.1097/gme.0b013e31816c5541
1383:Bleibel B, Nguyen H (2024),
1222:Palmer AR, Likis FE (2003).
952:Bleibel B, Nguyen H (2024).
722:10.1016/j.mayocp.2017.08.019
581:and extreme pain to lead to
479:
407:
7:
3315:Pelvic inflammatory disease
905:Flores SA, Hall CA (2024),
571:
379:increased urinary frequency
223:. Other causes may include
10:
3430:
3310:Pelvic congestion syndrome
2740:Fallopian tube obstruction
2423:10.1016/j.jsxm.2020.10.016
2157:10.1186/s12905-023-02645-0
1998:10.1007/s00404-024-07552-9
1948:Kovacs P (15 March 2017).
1183:10.1007/s11154-021-09666-w
369:bleeding after intercourse
365:painful sexual intercourse
190:inflammation of the vagina
3359:Vestibular papillomatosis
3334:
3327:
3302:
3278:
3211:
3169:
3111:
3102:
3058:
3003:
2985:
2962:
2938:
2928:Metropathia haemorrhagica
2830:
2792:
2783:
2774:
2725:
2626:
2610:
2538:
2457:
2376:10.1016/j.jep.2020.113760
2229:Smith J (6 August 2018).
1788:Palacios S (2009-08-20).
1724:American Family Physician
1637:American Family Physician
1487:(Supplement_3): 154–165.
1351:American Family Physician
295:
272:Anti-Estrogen Medications
175:
164:
144:
134:
117:
106:
98:
86:
73:
61:
56:
47:
39:
34:
2695:Follicular cyst of ovary
2294:10.3390/cosmetics8030056
1856:10.1177/1203475417708165
1759:10.1177/1203475417708165
817:10.6118/jmm.2015.21.2.65
608:
391:urinary tract infections
214:urinary tract infections
93:Urinary tract infections
3193:Sexual arousal disorder
3149:Candidal vulvovaginitis
2807:Endometrial hyperplasia
1838:Hum M, Dytoc M (2017).
709:Mayo Clinic Proceedings
281:Breast Cancer Survivors
2636:Endometriosis of ovary
1434:The Nurse Practitioner
503:dehydroepiandrosterone
417:Differential Diagnosis
210:burning with urination
146:Differential diagnosis
3080:Vesicouterine fistula
3023:Cervical incompetence
2948:Recurrent miscarriage
2886:Premenstrual syndrome
2747:Fallopian tube cancer
2325:Current Drug Delivery
1135:"Menopause (Nursing)"
544:menopause for women.
403:thin, clear discharge
263:Arterial Embolization
130:, certain medications
3238:Rectovaginal fistula
2663:Poor ovarian reserve
2051:10.7759/cureus.44191
1061:10.2147/IJWH.S158913
907:"Atrophic Vaginitis"
550:vulvovaginal atrophy
532:Vulvovaginal atrophy
433:Clinical Examination
332:After menopause the
151:Infectious vaginitis
3288:Postcoital bleeding
3216:Urogenital fistulas
3144:Bacterial vaginosis
2797:Asherman's syndrome
1686:10.7759/cureus.7586
423:bacterial vaginosis
322:medroxyprogesterone
3173:Sexual dysfunction
3139:Atrophic vaginitis
3075:Retroverted uterus
3038:Female infertility
3018:Cervical dysplasia
2943:Female infertility
2735:Female infertility
2690:Corpus luteum cyst
2646:Ovulatory disorder
2641:Female infertility
2539:External resources
2144:BMC Women's Health
1288:10.3390/jpm5020050
870:10.3390/jpm5020050
541:atrophic vaginitis
536:atrophic vaginitis
397:difficulty sitting
376:blood in the urine
334:vaginal epithelium
328:Signs and symptoms
186:Atrophic vaginitis
159:contact dermatitis
35:Atrophic vaginitis
3386:
3385:
3382:
3381:
3323:
3322:
3298:
3297:
3231:Obstetric fistula
3129:Vaginal discharge
3098:
3097:
3043:Cervical stenosis
2958:
2957:
2812:Endometrial polyp
2770:
2769:
2700:Theca lutein cyst
2562:
2561:
2199:"Vaginal Atrophy"
2104:10.6118/jmm.21028
1537:978-3-642-95584-6
1385:"Vaginal Atrophy"
1357:(10): 3090–3096.
954:"Vaginal Atrophy"
753:Ferri FF (2016).
715:(12): 1842–1849.
583:suicidal ideation
465:Papanicolaou test
400:difficulty wiping
394:painful urination
373:painful urination
287:Cigarette smoking
183:
182:
140:Based on symptoms
136:Diagnostic method
29:Medical condition
16:(Redirected from
3421:
3414:Vaginal diseases
3354:Kraurosis vulvae
3349:Bartholin's cyst
3332:
3331:
3283:Vaginal bleeding
3176:
3109:
3108:
3085:Uterine prolapse
2913:Menometrorrhagia
2837:
2790:
2789:
2781:
2780:
2680:Ovarian apoplexy
2624:
2623:
2615:
2614:
2589:
2582:
2575:
2566:
2565:
2455:
2454:
2443:
2442:
2402:
2396:
2395:
2355:
2349:
2348:
2320:
2307:
2306:
2296:
2272:
2266:
2265:
2253:
2247:
2246:
2244:
2242:
2226:
2220:
2219:
2218:
2217:
2194:
2188:
2187:
2177:
2159:
2135:
2126:
2125:
2115:
2083:
2074:
2073:
2063:
2053:
2029:
2018:
2017:
1977:
1966:
1965:
1963:
1961:
1945:
1934:
1933:
1893:
1876:
1875:
1835:
1826:
1825:
1785:
1779:
1778:
1738:
1732:
1731:
1715:
1709:
1708:
1698:
1688:
1664:
1653:
1652:
1628:
1622:
1621:
1619:
1618:
1603:
1597:
1596:
1567:
1542:
1541:
1519:
1513:
1512:
1472:
1466:
1465:
1425:
1406:
1405:
1404:
1403:
1380:
1367:
1366:
1342:
1319:
1318:
1308:
1290:
1266:
1260:
1259:
1219:
1213:
1212:
1202:
1162:
1156:
1155:
1154:
1153:
1130:
1124:
1123:
1122:
1121:
1098:
1092:
1091:
1081:
1063:
1039:
1033:
1032:
1022:
982:
976:
975:
973:
972:
949:
928:
927:
926:
925:
902:
893:
892:
882:
872:
848:
839:
838:
828:
796:
771:
770:
750:
735:
734:
724:
700:
626:
619:
511:Vaginal dilators
52:
32:
31:
21:
3429:
3428:
3424:
3423:
3422:
3420:
3419:
3418:
3389:
3388:
3387:
3378:
3319:
3294:
3274:
3207:
3170:
3165:
3161:Vaginal atresia
3094:
3054:
3013:Cervical cancer
2999:
2981:
2977:Uterine fibroid
2954:
2934:
2918:Polymenorrhagia
2859:Oligoamenorrhea
2831:
2826:
2766:
2721:
2717:Ovarian torsion
2606:
2596:Female diseases
2593:
2563:
2558:
2557:
2534:
2533:
2466:
2452:
2447:
2446:
2403:
2399:
2356:
2352:
2321:
2310:
2273:
2269:
2254:
2250:
2240:
2238:
2227:
2223:
2215:
2213:
2195:
2191:
2136:
2129:
2084:
2077:
2030:
2021:
1978:
1969:
1959:
1957:
1946:
1937:
1894:
1879:
1836:
1829:
1786:
1782:
1739:
1735:
1716:
1712:
1665:
1656:
1629:
1625:
1616:
1614:
1605:
1604:
1600:
1568:
1545:
1538:
1520:
1516:
1473:
1469:
1426:
1409:
1401:
1399:
1381:
1370:
1343:
1322:
1267:
1263:
1220:
1216:
1163:
1159:
1151:
1149:
1131:
1127:
1119:
1117:
1099:
1095:
1040:
1036:
983:
979:
970:
968:
950:
931:
923:
921:
903:
896:
849:
842:
797:
774:
767:
751:
738:
701:
640:
635:
630:
629:
620:
616:
611:
574:
529:
520:
482:
473:
456:
454:Lab Examination
435:
419:
410:
359:white discharge
330:
298:
241:
206:urge to urinate
194:tissue thinning
192:as a result of
30:
23:
22:
18:Vaginal atrophy
15:
12:
11:
5:
3427:
3417:
3416:
3411:
3406:
3401:
3384:
3383:
3380:
3379:
3377:
3376:
3371:
3366:
3361:
3356:
3351:
3346:
3340:
3338:
3329:
3325:
3324:
3321:
3320:
3318:
3317:
3312:
3306:
3304:
3300:
3299:
3296:
3295:
3293:
3292:
3291:
3290:
3279:
3276:
3275:
3273:
3272:
3271:
3270:
3265:
3260:
3255:
3250:
3240:
3235:
3234:
3233:
3228:
3223:
3221:Ureterovaginal
3212:
3209:
3208:
3206:
3205:
3200:
3198:Vaginal cancer
3195:
3190:
3185:
3179:
3177:
3167:
3166:
3164:
3163:
3158:
3153:
3152:
3151:
3146:
3141:
3131:
3122:
3112:
3106:
3100:
3099:
3096:
3095:
3093:
3092:
3090:Uterine cancer
3087:
3082:
3077:
3072:
3062:
3060:
3056:
3055:
3053:
3052:
3050:Nabothian cyst
3047:
3046:
3045:
3035:
3030:
3028:Cervical polyp
3025:
3020:
3015:
3009:
3007:
3001:
3000:
2998:
2997:
2991:
2989:
2983:
2982:
2980:
2979:
2974:
2968:
2966:
2960:
2959:
2956:
2955:
2953:
2952:
2951:
2950:
2939:
2936:
2935:
2933:
2932:
2931:
2930:
2922:
2921:
2920:
2915:
2907:
2906:
2905:
2900:
2890:
2889:
2888:
2883:
2873:
2872:
2871:
2866:
2864:Oligomenorrhea
2861:
2856:
2851:
2840:
2838:
2828:
2827:
2825:
2824:
2819:
2814:
2809:
2804:
2799:
2793:
2787:
2778:
2772:
2771:
2768:
2767:
2765:
2764:
2759:
2754:
2749:
2744:
2743:
2742:
2731:
2729:
2727:Fallopian tube
2723:
2722:
2720:
2719:
2714:
2712:Ovarian cancer
2709:
2704:
2703:
2702:
2697:
2692:
2682:
2677:
2672:
2667:
2666:
2665:
2660:
2659:
2658:
2656:Oligoovulation
2653:
2638:
2632:
2630:
2621:
2612:
2608:
2607:
2592:
2591:
2584:
2577:
2569:
2560:
2559:
2556:
2555:
2543:
2542:
2540:
2536:
2535:
2532:
2531:
2520:
2509:
2498:
2483:
2467:
2462:
2461:
2459:
2458:Classification
2451:
2450:External links
2448:
2445:
2444:
2417:(1): 156–166.
2397:
2350:
2331:(9): 815–822.
2308:
2267:
2248:
2221:
2189:
2127:
2075:
2019:
1992:(2): 631–641.
1967:
1935:
1908:(4): 726–729.
1877:
1850:(5): 418–424.
1827:
1800:(4): 315–318.
1780:
1753:(5): 418–424.
1733:
1710:
1654:
1643:(5): 321–329.
1623:
1598:
1579:(3): 349–354.
1543:
1536:
1514:
1467:
1407:
1368:
1320:
1261:
1234:(4): 282–284.
1214:
1177:(3): 333–355.
1157:
1125:
1093:
1034:
997:(4): 483–491.
977:
929:
894:
840:
772:
765:
736:
637:
636:
634:
631:
628:
627:
613:
612:
610:
607:
573:
570:
528:
525:
519:
516:
491:estrogen cream
481:
478:
472:
469:
455:
452:
434:
431:
427:trichomoniasis
418:
415:
409:
406:
405:
404:
401:
398:
395:
392:
389:
386:
383:
380:
377:
374:
371:
366:
363:
360:
357:
354:
351:
348:
345:
342:
329:
326:
297:
294:
290:
289:
284:
278:
275:
269:
266:
259:
253:
240:
237:
181:
180:
177:
173:
172:
166:
162:
161:
148:
142:
141:
138:
132:
131:
121:
115:
114:
108:
104:
103:
100:
96:
95:
90:
84:
83:
77:
71:
70:
65:
59:
58:
54:
53:
45:
44:
41:
37:
36:
28:
9:
6:
4:
3:
2:
3426:
3415:
3412:
3410:
3407:
3405:
3404:Inflammations
3402:
3400:
3397:
3396:
3394:
3375:
3372:
3370:
3367:
3365:
3362:
3360:
3357:
3355:
3352:
3350:
3347:
3345:
3344:Vulvar cancer
3342:
3341:
3339:
3337:
3333:
3330:
3326:
3316:
3313:
3311:
3308:
3307:
3305:
3301:
3289:
3286:
3285:
3284:
3281:
3280:
3277:
3269:
3266:
3264:
3261:
3259:
3256:
3254:
3251:
3249:
3246:
3245:
3244:
3241:
3239:
3236:
3232:
3229:
3227:
3226:Vesicovaginal
3224:
3222:
3219:
3218:
3217:
3214:
3213:
3210:
3204:
3201:
3199:
3196:
3194:
3191:
3189:
3186:
3184:
3181:
3180:
3178:
3175:
3174:
3168:
3162:
3159:
3157:
3154:
3150:
3147:
3145:
3142:
3140:
3137:
3136:
3135:
3132:
3130:
3126:
3123:
3121:
3117:
3114:
3113:
3110:
3107:
3105:
3101:
3091:
3088:
3086:
3083:
3081:
3078:
3076:
3073:
3071:
3067:
3064:
3063:
3061:
3057:
3051:
3048:
3044:
3041:
3040:
3039:
3036:
3034:
3031:
3029:
3026:
3024:
3021:
3019:
3016:
3014:
3011:
3010:
3008:
3006:
3002:
2996:
2993:
2992:
2990:
2988:
2984:
2978:
2975:
2973:
2970:
2969:
2967:
2965:
2961:
2949:
2946:
2945:
2944:
2941:
2940:
2937:
2929:
2926:
2925:
2923:
2919:
2916:
2914:
2911:
2910:
2908:
2904:
2901:
2899:
2896:
2895:
2894:
2891:
2887:
2884:
2882:
2879:
2878:
2877:
2874:
2870:
2867:
2865:
2862:
2860:
2857:
2855:
2854:Hypomenorrhea
2852:
2850:
2847:
2846:
2845:
2842:
2841:
2839:
2836:
2835:
2829:
2823:
2820:
2818:
2817:Endometriosis
2815:
2813:
2810:
2808:
2805:
2803:
2800:
2798:
2795:
2794:
2791:
2788:
2786:
2782:
2779:
2777:
2773:
2763:
2760:
2758:
2755:
2753:
2752:Hematosalpinx
2750:
2748:
2745:
2741:
2738:
2737:
2736:
2733:
2732:
2730:
2728:
2724:
2718:
2715:
2713:
2710:
2708:
2705:
2701:
2698:
2696:
2693:
2691:
2688:
2687:
2686:
2683:
2681:
2678:
2676:
2673:
2671:
2670:Mittelschmerz
2668:
2664:
2661:
2657:
2654:
2652:
2649:
2648:
2647:
2644:
2643:
2642:
2639:
2637:
2634:
2633:
2631:
2629:
2625:
2622:
2620:
2616:
2613:
2609:
2605:
2601:
2597:
2590:
2585:
2583:
2578:
2576:
2571:
2570:
2567:
2554:
2550:
2549:
2545:
2544:
2541:
2537:
2530:
2526:
2525:
2521:
2519:
2515:
2514:
2510:
2508:
2504:
2503:
2499:
2497:
2493:
2492:
2488:
2484:
2482:
2478:
2477:
2473:
2469:
2468:
2465:
2460:
2456:
2440:
2436:
2432:
2428:
2424:
2420:
2416:
2412:
2408:
2401:
2393:
2389:
2385:
2381:
2377:
2373:
2369:
2365:
2361:
2354:
2346:
2342:
2338:
2334:
2330:
2326:
2319:
2317:
2315:
2313:
2304:
2300:
2295:
2290:
2286:
2282:
2278:
2271:
2263:
2259:
2252:
2236:
2232:
2225:
2212:
2208:
2204:
2200:
2193:
2185:
2181:
2176:
2171:
2167:
2163:
2158:
2153:
2149:
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2080:
2071:
2067:
2062:
2057:
2052:
2047:
2044:(8): e44191.
2043:
2039:
2035:
2028:
2026:
2024:
2015:
2011:
2007:
2003:
1999:
1995:
1991:
1987:
1983:
1976:
1974:
1972:
1955:
1951:
1944:
1942:
1940:
1931:
1927:
1923:
1919:
1915:
1911:
1907:
1903:
1899:
1892:
1890:
1888:
1886:
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1861:
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1764:
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1752:
1748:
1744:
1737:
1730:(7): 807–815.
1729:
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1373:
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1030:
1026:
1021:
1016:
1012:
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1000:
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988:
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963:
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920:
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901:
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886:
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858:
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847:
845:
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832:
827:
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810:
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802:
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785:
783:
781:
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766:9780323448383
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743:
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710:
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697:
695:
693:
691:
689:
687:
685:
683:
681:
679:
677:
675:
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671:
669:
667:
665:
663:
661:
659:
657:
655:
653:
651:
649:
647:
645:
643:
638:
624:
618:
614:
606:
602:
598:
594:
590:
586:
584:
580:
569:
567:
563:
560:, vestibule,
559:
555:
551:
547:
542:
537:
533:
524:
515:
512:
508:
507:laser therapy
504:
500:
495:
492:
486:
477:
468:
466:
461:
451:
449:
445:
441:
430:
428:
424:
414:
402:
399:
396:
393:
390:
387:
384:
381:
378:
375:
372:
370:
367:
364:
361:
358:
355:
352:
349:
346:
343:
340:
339:
338:
335:
325:
323:
319:
315:
310:
307:
306:breast cancer
302:
293:
288:
285:
282:
279:
276:
273:
270:
267:
264:
260:
257:
254:
251:
247:
246:
245:
236:
232:
230:
226:
225:breastfeeding
222:
217:
215:
211:
207:
203:
202:pain with sex
199:
195:
191:
187:
178:
174:
171:
167:
163:
160:
156:
155:vulvar cancer
152:
149:
147:
143:
139:
137:
133:
129:
128:breastfeeding
125:
122:
120:
116:
113:
109:
105:
101:
97:
94:
91:
89:
88:Complications
85:
81:
80:Pain with sex
78:
76:
72:
69:
66:
64:
60:
55:
51:
46:
42:
38:
33:
27:
19:
3263:Sigmoidocele
3171:
3138:
3116:Hematocolpos
2995:Parametritis
2903:Metrorrhagia
2881:Dysmenorrhea
2834:Menstruation
2832:
2822:Endometritis
2757:Hydrosalpinx
2685:Ovarian cyst
2546:
2522:
2511:
2500:
2485:
2470:
2414:
2410:
2400:
2367:
2363:
2353:
2328:
2324:
2284:
2280:
2270:
2261:
2251:
2239:. Retrieved
2234:
2224:
2214:, retrieved
2202:
2192:
2147:
2143:
2095:
2091:
2041:
2037:
1989:
1985:
1958:. Retrieved
1953:
1905:
1901:
1847:
1843:
1797:
1793:
1783:
1750:
1746:
1736:
1727:
1723:
1713:
1679:(4): e7586.
1676:
1672:
1640:
1636:
1626:
1615:. Retrieved
1610:
1601:
1576:
1572:
1527:
1523:
1517:
1484:
1480:
1470:
1440:(1): 22–28.
1437:
1433:
1400:, retrieved
1388:
1354:
1350:
1281:(2): 50–66.
1278:
1274:
1264:
1231:
1227:
1217:
1174:
1170:
1160:
1150:, retrieved
1138:
1128:
1118:, retrieved
1106:
1096:
1051:
1047:
1037:
994:
990:
980:
969:. Retrieved
957:
922:, retrieved
910:
863:(2): 50–66.
860:
856:
811:(2): 65–71.
808:
804:
755:
712:
708:
617:
603:
599:
595:
591:
587:
575:
549:
540:
535:
531:
530:
521:
518:Epidemiology
496:
487:
483:
474:
458:The vaginal
457:
440:labia minora
436:
420:
411:
382:incontinence
331:
311:
303:
299:
291:
250:Oophorectomy
242:
239:Risk Factors
233:
218:
185:
184:
119:Risk factors
26:
3268:Urethrocele
3183:Dyspareunia
3156:Hydrocolpos
3120:Hydrocolpos
3066:Hematometra
2987:Parametrium
2972:Adenomyosis
2785:Endometrium
2762:Salpingitis
2651:Anovulation
2548:MedlinePlus
2098:(1): 9–16.
1956:. WebMD LLC
1611:NHS Choices
1054:: 387–395.
991:Climacteric
527:Terminology
413:diagnosis.
196:due to low
40:Other names
3393:Categories
3369:Vulvodynia
3253:Enterocele
3203:Vaginismus
3125:Leukorrhea
3033:Cervicitis
2964:Myometrium
2849:Amenorrhea
2675:Oophoritis
2513:DiseasesDB
2370:: 113760.
2241:21 October
2216:2024-07-26
2203:StatPearls
2150:(1): 494.
1960:7 February
1617:2018-02-07
1402:2024-08-01
1389:StatPearls
1152:2024-07-30
1139:StatPearls
1120:2024-07-30
1107:StatPearls
971:2024-07-25
958:StatPearls
924:2024-07-26
911:StatPearls
633:References
501:, vaginal
248:Bilateral
68:Gynecology
3399:Menopause
3258:Rectocele
3248:Cystocele
3134:Vaginitis
2524:SNOMED CT
2431:1743-6109
2384:0378-8741
2303:2079-9284
2287:(3): 56.
2281:Cosmetics
2262:STAT News
2166:1472-6874
2006:1432-0711
1922:1072-3714
1902:Menopause
1864:1615-7109
1814:0378-5122
1794:Maturitas
1767:1203-4754
1573:Maturitas
1501:1743-6109
1454:0361-1817
1297:2075-4426
1248:1526-9523
1191:1389-9155
1070:1179-1411
1011:1369-7137
494:avoided.
480:Treatment
408:Diagnosis
318:nafarelin
221:menopause
176:Frequency
165:Treatment
124:Menopause
102:Long term
63:Specialty
3364:Vulvitis
3328:External
3243:Prolapse
3070:Pyometra
2611:Internal
2604:genitals
2529:52441000
2439:33293236
2392:33383112
2345:32640956
2211:32644723
2184:37716966
2175:10505316
2122:35534426
2070:37767255
2061:10520994
2014:38898186
1954:Medscape
1930:18427354
1872:28453946
1822:19493638
1775:28453946
1705:32399320
1649:29671516
1593:25179577
1509:16422792
1462:21150811
1397:32644723
1363:10839558
1315:25815692
1256:12867914
1209:34405378
1147:33760453
1115:36943992
1088:30104904
1029:25845383
966:32644723
919:33232011
889:25815692
835:26357643
731:29202940
579:necrosis
572:Research
558:clitoris
356:pressure
353:soreness
198:estrogen
170:estrogen
168:Vaginal
112:estrogen
110:Lack of
99:Duration
75:Symptoms
3059:General
2598:of the
2507:D059268
2113:9086347
1696:7212735
1306:4493485
1200:9156507
1079:6074805
1020:4581591
880:4493485
826:4561742
566:bladder
562:urethra
350:burning
347:itching
341:dryness
314:danazol
229:smoking
3104:Vagina
3005:Cervix
2924:Other
2909:Mixed
2893:Timing
2776:Uterus
2619:Adnexa
2600:pelvis
2553:000892
2437:
2429:
2390:
2382:
2343:
2301:
2235:MDedge
2209:
2182:
2172:
2164:
2120:
2110:
2068:
2058:
2038:Cureus
2012:
2004:
1928:
1920:
1870:
1862:
1820:
1812:
1773:
1765:
1703:
1693:
1673:Cureus
1647:
1591:
1534:
1507:
1499:
1460:
1452:
1395:
1361:
1313:
1303:
1295:
1254:
1246:
1207:
1197:
1189:
1145:
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1086:
1076:
1068:
1027:
1017:
1009:
964:
917:
887:
877:
833:
823:
763:
729:
505:, and
448:vagina
444:cervix
320:, and
296:Causes
107:Causes
3336:Vulva
3303:Other
2628:Ovary
2518:32516
2496:627.3
2481:N95.2
1526:[
609:Notes
554:labia
2876:Pain
2844:Flow
2602:and
2502:MeSH
2491:9-CM
2435:PMID
2427:ISSN
2388:PMID
2380:ISSN
2341:PMID
2299:ISSN
2243:2019
2207:PMID
2180:PMID
2162:ISSN
2118:PMID
2066:PMID
2010:PMID
2002:ISSN
1962:2018
1926:PMID
1918:ISSN
1868:PMID
1860:ISSN
1818:PMID
1810:ISSN
1771:PMID
1763:ISSN
1701:PMID
1645:PMID
1589:PMID
1532:ISBN
1505:PMID
1497:ISSN
1458:PMID
1450:ISSN
1393:PMID
1359:PMID
1311:PMID
1293:ISSN
1252:PMID
1244:ISSN
1205:PMID
1187:ISSN
1143:PMID
1111:PMID
1084:PMID
1066:ISSN
1025:PMID
1007:ISSN
962:PMID
915:PMID
885:PMID
831:PMID
761:ISBN
727:PMID
564:and
534:and
344:pain
2487:ICD
2472:ICD
2419:doi
2372:doi
2368:270
2333:doi
2289:doi
2170:PMC
2152:doi
2108:PMC
2100:doi
2056:PMC
2046:doi
1994:doi
1990:310
1910:doi
1852:doi
1802:doi
1755:doi
1691:PMC
1681:doi
1581:doi
1489:doi
1442:doi
1301:PMC
1283:doi
1236:doi
1195:PMC
1179:doi
1074:PMC
1056:doi
1015:PMC
999:doi
875:PMC
865:doi
821:PMC
813:doi
717:doi
208:or
188:is
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