A Review of Vulvovaginal Atrophy as Part of Genitourinary Syndrome of Menopause

In this narrative review, we evaluate and discuss current literature on the assessment of vulvovaginal atrophy as part of the genitourinary syndrome of menopause. Publications discussing clinical evaluation methods, including physical exam, cytology, pH, and symptom questionnaires, as well as laboratory evaluation through histology and genetic analysis, were reviewed. A wide variety of methods are used to clinically evaluate the signs and symptoms of atrophy; however, these tools lack consistency and validation across publications. We also appraised the pertinent publications evaluating the genetic changes in the vagina occurring with menopause and subsequent treatment. More research is needed to validate and standardize clinical evaluation techniques and to further define the genetic pathway alterations to develop targeted therapies in the future.