OBJECTIVES: Anogenital distance (AGD) represents the space between labia posterior commissure and anus. This was pilot study to investigate how menopause and so lack of oestrogens affects AGD. METHODS: A total of 109 patients were enrolled. AGD was measured in lithotomy position using sterile paper ruler. Anogenital index (AGI) was used to control 2 variables of height and weight (body mass index, kg/m2). Vaginal health index (VHI) was used to evaluate vaginal wellness. Female sexual function index (FSFI) questionnaire was administered to all women to evaluate the impact of menopause on their sexual function. RESULTS: AGD (30.87 ± 2.98 vs. 17.57 ± 2.18; P = 0.0001) and AGI (1.40 ± 0.21 vs. 0.70 ± 0.15; P = 0.0001) were both significantly lower in the postmenopausal group. Postmenopausal women were affected by vulvovaginal atrophy (VVA) significantly. Thus, VHI scores were dramatically worse in postmenopausal group (23.95 ± 1.28 vs. 10.75 ± 3.41; P = 0.0001) as well as FSFI results (32.68 ± 2.25 vs. 19.78 ± 5.46; P = 0.0001). CONCLUSIONS: This study confirms that AGD in post-menopausal women was significantly shorter than AGD in premenopausal women, correlating with an increase of VVA and sexual impairment. Changes of AGD and AGI demonstrated to predict hormonal changes that may occur after menopause.
Anal Canal ; Atrophy ; Female ; Humans ; Menopause ; Pilot Projects ; Sexuality

Objectives: To compare the efficacy and safety of three different treatment options (vaginal estriol, vaginal dehydroepiandrosterone (DHEA), and ospemifene) for treating genitourinary syndrome of menopause (GSM) in breast cancer and gynecologic cancer survivors. Methods: A retrospective comparative analysis was performed among 185 cancer survivors (including breast, endometrial, ovarian, cervical, and vulvar cancer) affected by GSM. Women were divided into three groups according to the prescribed therapy (vaginal estriol, vaginal DHEA, and ospemifene). Safety and efficacy of therapies were assessed over a 6-month follow-up. Improvement in symptoms was compared using the following questionnaires: Female Sexual Function Index, Female Sexual Distress Scale, Visual Analogue Scale (VAS)-dyspareunia, VAS-vulvar pain, Short Form (36) Health Survey, and Patients’ Impression of Global Improvement. Cancer recurrence was evaluated according to oncological protocol. Results: After the 6-month follow-up, no significant endometrial thickening or cancer recurrence was observed in any group. The rate of sexually active women significantly increased in all groups, as well as the frequency of sexual intercourse. Scores on questionnaires assessing women’s sexual function significantly improved in all patients. Women also complained of less vulvar pain and dyspareunia.Safety and efficacy of treatment were comparable between the three groups for all items except for dyspareunia. Patients taking ospemifene complained of less dyspareunia than those receiving local hormone treatment. Conclusions Vaginal estriol, vaginal DHEA, and ospemifene were effective in improving symptoms of GSM in cancer survivors and were not associated with cancer recurrence over the 6-month follow-up. Ospemifene was more effective than local hormones in treating dyspareunia.

Objectives: To compare the efficacy and safety of three different treatment options (vaginal estriol, vaginal dehydroepiandrosterone (DHEA), and ospemifene) for treating genitourinary syndrome of menopause (GSM) in breast cancer and gynecologic cancer survivors. Methods: A retrospective comparative analysis was performed among 185 cancer survivors (including breast, endometrial, ovarian, cervical, and vulvar cancer) affected by GSM. Women were divided into three groups according to the prescribed therapy (vaginal estriol, vaginal DHEA, and ospemifene). Safety and efficacy of therapies were assessed over a 6-month follow-up. Improvement in symptoms was compared using the following questionnaires: Female Sexual Function Index, Female Sexual Distress Scale, Visual Analogue Scale (VAS)-dyspareunia, VAS-vulvar pain, Short Form (36) Health Survey, and Patients’ Impression of Global Improvement. Cancer recurrence was evaluated according to oncological protocol. Results: After the 6-month follow-up, no significant endometrial thickening or cancer recurrence was observed in any group. The rate of sexually active women significantly increased in all groups, as well as the frequency of sexual intercourse. Scores on questionnaires assessing women’s sexual function significantly improved in all patients. Women also complained of less vulvar pain and dyspareunia.Safety and efficacy of treatment were comparable between the three groups for all items except for dyspareunia. Patients taking ospemifene complained of less dyspareunia than those receiving local hormone treatment. Conclusions Vaginal estriol, vaginal DHEA, and ospemifene were effective in improving symptoms of GSM in cancer survivors and were not associated with cancer recurrence over the 6-month follow-up. Ospemifene was more effective than local hormones in treating dyspareunia.

Objectives: To compare the efficacy and safety of three different treatment options (vaginal estriol, vaginal dehydroepiandrosterone (DHEA), and ospemifene) for treating genitourinary syndrome of menopause (GSM) in breast cancer and gynecologic cancer survivors. Methods: A retrospective comparative analysis was performed among 185 cancer survivors (including breast, endometrial, ovarian, cervical, and vulvar cancer) affected by GSM. Women were divided into three groups according to the prescribed therapy (vaginal estriol, vaginal DHEA, and ospemifene). Safety and efficacy of therapies were assessed over a 6-month follow-up. Improvement in symptoms was compared using the following questionnaires: Female Sexual Function Index, Female Sexual Distress Scale, Visual Analogue Scale (VAS)-dyspareunia, VAS-vulvar pain, Short Form (36) Health Survey, and Patients’ Impression of Global Improvement. Cancer recurrence was evaluated according to oncological protocol. Results: After the 6-month follow-up, no significant endometrial thickening or cancer recurrence was observed in any group. The rate of sexually active women significantly increased in all groups, as well as the frequency of sexual intercourse. Scores on questionnaires assessing women’s sexual function significantly improved in all patients. Women also complained of less vulvar pain and dyspareunia.Safety and efficacy of treatment were comparable between the three groups for all items except for dyspareunia. Patients taking ospemifene complained of less dyspareunia than those receiving local hormone treatment. Conclusions Vaginal estriol, vaginal DHEA, and ospemifene were effective in improving symptoms of GSM in cancer survivors and were not associated with cancer recurrence over the 6-month follow-up. Ospemifene was more effective than local hormones in treating dyspareunia.