Using advanced analytics to help identify women who are more likely to have a severe subjective experience of vulvovaginal atrophy: a modeling study

Figures & data

Table 1. Vulvovaginal atrophy symptoms included in the dependent variable used for model development.

	Absent	Mild	Moderate	Severe
Dryness (inside the vagina)	0	1	2	3
Dryness (outside at the external genitals)	0	1	2	3
Pain during intercourse (inside)	0	1	2	3
Pain during intercourse (at penetration)	0	1	2	3
Genital discomfort during exercise	0	1	2	3
Bleeding during intercourse	0	1	2	3
Bleeding during sexual contact	0	1	2	3
Burning or irritation (inside the vagina)	0	1	2	3
Burning or irritation (outside at the external genitals)	0	1	2	3
Itching (inside the vagina)	0	1	2	3
Itching (outside at the external genitals)	0	1	2	3
Vaginal discharge	0	1	2	3
Urinary incontinence	0	1	2	3
Urinary urgency	0	1	2	3
Urinary frequency	0	1	2	3
Urinary difficulties	0	1	2	3
Recurrent urinary tract infections	0	1	2	3
Cystitis associated with sexual intercourse	0	1	2	3
Abdominal pain	0	1	2	3

Notes: We are interested in understanding which VVA symptoms affect you and the level of discomfort, if any, associated to each of them. We would like you to select the number which best describes the level of discomfort you experience.

Table 2. Independent variables included in the models.

Group	Variable
Demographic and clinical	Age
	Weight
	Height
	Education
	Employment status
	Ethnicity
	Relationship status
	Duration of marriage
Behavioral	Tobacco use
	Alcohol use
	Caffeine use
	Tea use
	Sexually active or not
	Frequency of sexual intercourse per month
Medical	Age at last menstruation
	Number of years since menopause
	Type of menopause (natural, surgical, medication-induced)
	Children
	Abortion
	Chronic disease
	Surgery for prolapse or urinary
	Breast disease (benign, malignant)
	Hysterectomy
	Currently using treatment for comorbidities
Day-to-day impact of vaginal	Walk at own speed
aging (DIVA)	Wear the underwear you want
	Use the toilet
	Sit for more than an hour
	Get a good night’s sleep
	Depressed or down
	Embarrassed
	Feel bad about yourself
	Desire or interest in sex
	Frequency of intercourse
	Ability to be aroused
	Desire or interest in being in a sexual relationship
	Confidence in ability to satisfy partner
Clinical severity	Vaginal Health Index Score

Figure 1. Model characteristics: receiver operating characteristic curves (panels A, C, E, G) and relative contribution of variables (panels B, D, F, H). AUC: area under the curve; DIVA: day-to-day impact of vaginal aging.

Table

Vaginal Health Index
Overall elasticity	None	Poor	Fair	Good
Fluid secretion	None	Scant	Superficial	Moderate
pH	6.1	5.6–6.0	5.1–5.5	4.7–5.0
Epithelial mucosa	Petechiae before contact	Bleeds with light contact	Bleeds with scraping	Not friable Thin mucosa
Moisture	None, mucosa inflamed	None, mucosa not inflamed	Minimal	Moderate
Overall elasticity	None	Poor	Fair	Good