TY - JOUR
T1 - The Gynogram
T2 - A Multicentric Validation of a New Psychometric Tool to Assess Coital Pain Associated With VVA and Its Impact on Sexual Quality of Life in Menopausal Women
AU - Gynogram Study Group
AU - Nappi, Rossella E.
AU - Graziottin, Alessandra
AU - Mollaioli, Daniele
AU - Limoncin, Erika
AU - Ciocca, Giacomo
AU - Sansone, Andrea
AU - Meriggiola, Maria Cristina
AU - Becorpi, Angela Maria
AU - Maffei, Silvia
AU - Russo, Novella
AU - Jannini, Emmanuele A.
N1 - Funding Information:
Conflict of Interest: E.A.J. is or has been a paid consultant orspeaker for Bayer, Ibsa, Lorenzini Foundation, Lundbeck, Menarini, Otsuka, Pfizer, and Shionogi. R.E.N. declares fees for lectures, membership of advisory boards, and consultancy from Astellas, Bayer HealthCare, Endoceutics, Exceltis, Fidia, Gedeon Richter, MSD, Novo Nordisk, Palatin, Pfizer, Shionogi, Teva, and Theramex. AG has been a paid consultant or speaker for Alfasigma, Angelini, Bayer, Fagron, Gedeon–Richter, Lolipharm, Mylan, Recordati, Shionogi, Theramex. D.M., E.L., and G.C. have been paid speakers for Shionogi. E.L. was a Pfizer fellowship recipient. M.C.M. is or has been a paid consultant or speaker for Bayer, Merk, Ghedeon Richter, Shionogi, Italfarmaco. declares fees for lectures, and consultancy from Bayer HealthCare, MSD, Shionogi, and Theramex. A.S., A.M.B and S.M declare no competing interests for the present work.
Publisher Copyright:
© 2021 International Society for Sexual Medicine
PY - 2021/5
Y1 - 2021/5
N2 - Background: Vulvo-Vaginal Atrophy (VVA) affects about fifty percent of postmenopausal women, contributing more vulnerable sexual and psycho-relational equilibrium. To date, no psychometric instruments have been designed to assess the impact of coital pain associated with VVA on sexual quality of life. Aim: To validate a new psychometric tool, the Gynogram, able to investigate coital pain and to quantify its impact on sexual well-being in menopause. Methods: 214 sexually active postmenopausal women were enrolled in the study during clinical consultations in gynecological outpatient clinics in Italy. After gynecological examination and evaluation of the presence of VVA, the study sample was divided in a clinical group (103 women with certified diagnosis of VVA) and in a control group (111 women without certified diagnosis of VVA) according to the Vaginal Health Index (VHI) cut-off. Factor, Reliability and Receiving Operating Characteristics (ROC) analysis were performed in order to validate our newly created Gynogram. Outcomes: A structured questionnaire, named Gynogram, to assess coital pain and its impact, and the Female Sexual Function Index (FSFI). Results: The factor analysis performed on the original form (80 items) reduced the Gynogram to 24 items. Reliability analysis conducted with Cronbach's Alpha coefficients showed high values in all the components (ranging from.813 to.972), both in the long and in the short form. The sensitivity analysis demonstrated that the Gynogram, with a cut-off ≤93, is able to recognize a clinically significant coital pain. With respect to the FSFI, statistically significant differences were found for all the domains. In addition, statistically significant differences were found for all the twelve factors of the Gynogram, showing that VVA profoundly affects the sexual quality of life of women in post-menopause. Clinical Translation: The utility of this tool consists in the possibility to improve prognosis, compliance/adherence and treatment outcomes. Strengths and Limitations: The Gynogram is able to evaluate and to quantify the impact of coital pain associated with VVA. Moreover, it can also recognize the areas of biopsychosocial functioning being more affected by this clinical condition. The main limit of the study is the impossibility to evaluate both mental health and partner's general and sexual health. Conclusions: The Gynogram is a new and validated psychometric tool able to detect the impact of symptomatic VVA on sexual quality of life among post-menopausal women, with a specific focus on the different areas of sexual functioning. Nappi RE, Graziottin A, Mollaioli A, et al. The Gynogram: A Multicentric Validation of a New Psychometric Tool to Assess Coital Pain Associated With VVA and Its Impact on Sexual Quality of Life in Menopausal Women. J Sex Med 2021;18:955–965.
AB - Background: Vulvo-Vaginal Atrophy (VVA) affects about fifty percent of postmenopausal women, contributing more vulnerable sexual and psycho-relational equilibrium. To date, no psychometric instruments have been designed to assess the impact of coital pain associated with VVA on sexual quality of life. Aim: To validate a new psychometric tool, the Gynogram, able to investigate coital pain and to quantify its impact on sexual well-being in menopause. Methods: 214 sexually active postmenopausal women were enrolled in the study during clinical consultations in gynecological outpatient clinics in Italy. After gynecological examination and evaluation of the presence of VVA, the study sample was divided in a clinical group (103 women with certified diagnosis of VVA) and in a control group (111 women without certified diagnosis of VVA) according to the Vaginal Health Index (VHI) cut-off. Factor, Reliability and Receiving Operating Characteristics (ROC) analysis were performed in order to validate our newly created Gynogram. Outcomes: A structured questionnaire, named Gynogram, to assess coital pain and its impact, and the Female Sexual Function Index (FSFI). Results: The factor analysis performed on the original form (80 items) reduced the Gynogram to 24 items. Reliability analysis conducted with Cronbach's Alpha coefficients showed high values in all the components (ranging from.813 to.972), both in the long and in the short form. The sensitivity analysis demonstrated that the Gynogram, with a cut-off ≤93, is able to recognize a clinically significant coital pain. With respect to the FSFI, statistically significant differences were found for all the domains. In addition, statistically significant differences were found for all the twelve factors of the Gynogram, showing that VVA profoundly affects the sexual quality of life of women in post-menopause. Clinical Translation: The utility of this tool consists in the possibility to improve prognosis, compliance/adherence and treatment outcomes. Strengths and Limitations: The Gynogram is able to evaluate and to quantify the impact of coital pain associated with VVA. Moreover, it can also recognize the areas of biopsychosocial functioning being more affected by this clinical condition. The main limit of the study is the impossibility to evaluate both mental health and partner's general and sexual health. Conclusions: The Gynogram is a new and validated psychometric tool able to detect the impact of symptomatic VVA on sexual quality of life among post-menopausal women, with a specific focus on the different areas of sexual functioning. Nappi RE, Graziottin A, Mollaioli A, et al. The Gynogram: A Multicentric Validation of a New Psychometric Tool to Assess Coital Pain Associated With VVA and Its Impact on Sexual Quality of Life in Menopausal Women. J Sex Med 2021;18:955–965.
KW - Coital Pain
KW - Menopause
KW - Sexual Health
KW - Sexual Quality of Life
KW - Vulvo-Vaginal Atrophy
UR - http://www.scopus.com/inward/record.url?scp=85105713275&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85105713275&partnerID=8YFLogxK
U2 - 10.1016/j.jsxm.2021.02.011
DO - 10.1016/j.jsxm.2021.02.011
M3 - Article
C2 - 33896758
AN - SCOPUS:85105713275
VL - 18
SP - 955
EP - 965
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
SN - 1743-6095
IS - 5
ER -