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The impact of rehabilitation on the quality of life of patients with vulvovaginal atrophy

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.537

Abstract

Aim: to evaluate the impact of rehabilitation on various components of quality of life (QoL) in patients with vulvovaginal atrophy (VVA).

Materials and Methods. A prospective comparative controlled longitudinal study involved 350 patients with VVA, divided into groups based on the type of menopause: surgical (n = 140) and natural (n = 140), with a control group of 70 women without VVA. Patients were further subdivided into those receiving complex "active" (groups 1A, 2A) and "passive" (groups 1B, 2B) rehabilitation. The study included 6 visits over 24 months, assessing QoL using the Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Modified Menopausal Index (MMI), Well-being, Activity, Mood questionnaire (WAM), Magnesium Deficiency Questionnaire (MDQ), and the Assessment Test of Magnesium Deficiency (ATMD).

Results. Women with surgical menopause had severe sexual dysfunction initially. Complex "active" rehabilitation significantly improved sexual function over time compared to "passive" rehabilitation. Surgical menopausal women had higher initial levels of anxiety and depression. "Active" rehabilitation significantly reduced these levels, reaching normal values within the first year. Patients with surgical menopause exhibited more severe menopausal symptoms. "Active" rehabilitation led to significant reductions in these symptoms, improved well-being, activity, and mood more significantly than "passive" rehabilitation, particularly in the first year. Complex "active" rehabilitation normalized magnesium deficiency indicators within three months, maintaining normal levels throughout the study.

Conclusion. Comprehensive "active" rehabilitation significantly improves sexual function, reduces anxiety and depression, alleviates menopausal symptoms, and enhances overall well-being in women with VVA, especially those in surgical menopause. Personalized rehabilitation programs are crucial for enhancing QoL in these patients.

About the Authors

D. M. Ampilogova
City Clinical Hospital No. 52, Moscow Healtcare Department, Branch No. 4
Russian Federation

Diana M. Ampilogova – MD, Obstetrician-Gynecologist

41 Dubravnaya Str., Moscow 125222



A. G. Solopova
Sechenov University
Russian Federation

Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health

Scopus Author ID: 6505479504

Researcher ID: Q-1385-2015

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



D. V. Blinov
Sechenov University; Institute for Preventive and Social Medicine; Moscow Haass Medical – Social Institute
Russian Federation

Dmitry V. Blinov – MD, PhD, MBA, Assistant, Department of Sports Medicine and Medical Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Sechenov University Head of Medical and Scientific Affairs, Institute for Preventive and Social Medicine; Associate Professor, Department of Sports, Physical and Rehabilitation Medicine, Moscow Haass Medical – Social Institute

Scopus Author ID: 6701744871

Researcher ID: E-8906-2017

RSCI: 9779-8290

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;
4–10 Sadovaya-Triumfalnaya Str., Moscow 127006;
5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056



G. K. Bykovshchenko
Sechenov University
Russian Federation

Georgy K. Bykovshchenko – 6th year Student

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



S. V. Khlopkova
Vorokhobov City Clinical Hospital No. 67, Moscow Healthcare Department
Russian Federation

Svetlana V. Khlopkova – MD, Head of the Department of Gynecology

2/44 Salyama Adilya Str., Moscow 123423



A. E. Ivanov
Branch “Oncology Center No. 1 of Yudin City Clinical Hospital, Moscow City Health Department"
Russian Federation

Alexander E. Ivanov – MD, PhD, Head of the Department of Oncogynecology

18А bldg. 8, Zagorodnoye Shosse, Moscow 117152



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What is already known about this subject?

► Vulvovaginal atrophy (VVA)is the major manifestation of genitourinary menopausal syndrome (GUMS) profoundly lowering the quality of life (QoL).

► There is a gap in long-term comparative controlled studies assessing rehabilitation effect on QoL in patients with VVA of various etiologies.

What are the new findings?

► A personalized rehabilitation program contributes to the improvement of all QoL aspects in patients with VVA, assessed with questionnaires during 2-year follow-up.

► Patients with VVA in surgical vs. natural menopause had more prominent decline in QoL, but recovery occurs faster while using comprehensive "active" rehabilitation.

How might it impact on clinical practice in the foreseeable future?

► Introducing into clinical practice an investigated program for comprehensive "active" rehabilitation in patients with VVA will improve the QoL in such patients, positively influencing the outcome.

Review

For citations:


Ampilogova D.M., Solopova A.G., Blinov D.V., Bykovshchenko G.K., Khlopkova S.V., Ivanov A.E. The impact of rehabilitation on the quality of life of patients with vulvovaginal atrophy. Obstetrics, Gynecology and Reproduction. 2024;18(3):338-351. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.537

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)