Prevalence of low genital tract complaints in postmenopausal women assessed with the Vulvovaginal Symptoms Questionnaire: Systematic review and meta-analysis

Aim: We evaluated the prevalence of low genital tract symptoms in postmenopausal women using the Vulvovaginal Symptoms Questionnaire (VSQ). Methods: Systematic review and meta-analysis of studies reporting results obtained using the VSQ. The study was registered at PROSPERO-University of York (CRD 2024570513). Electronic database searches were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies evaluating postmenopausal women using the VSQ as reported by the authors. The pooled proportions of vulvovaginal symptoms were calculated as the prevalence of symptoms with their 95% confidence interval (CI), using random effects and inverse variance methods. Results: We meta-analyzed seven cross-sectional studies with a low to moderate risk of bias, including 1455 postmenopausal women based on the VSQ. Prevalences of vulvovaginal symptoms were dryness at 46.75% (95% CI, 28.61%–65.34%); burning at 26.08% (95% CI, 13.98%–40.36%); discharge at 19.96% (95% CI, 11.04%–30.69%); hurting at 21.26% (95% CI, 10.53%–34.47%); irritation at 31.76% (95% CI, 21.34%–43.18%); itching at 33.30% (95% CI, 22.35%–45.23%); and odor at 23.14% (95% CI, 11.27%–37.67%). The sensitivity analyses showed that the prevalence trends were maintained. The prevalence of women without vulvovaginal symptoms was 29.81% (95% CI, 17.42%–43.91%). Conclusion: The VSQ provides detailed prevalences of vulvovaginal symptoms, ranging from vulvovaginal discharge in 19.96% to dryness in 46.75% of postmenopausal women. The VSQ allows for measuring subjective vulvovaginal symptoms in postmenopausal women and determining their prevalence.