Vulvovaginal Atrophy, Genital Menopause Syndrome: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
    • Inspection (viewing).
      • Skin and mucous membranes
      • Abdominal wall and inguinal region (groin area).
  • Gynecological examination
    • Inspection (speculum)
      • Vulva (external, primary female sex organs) [fluorine discharge)?, color?, foetor?, inflammation?, vesicle?, coating?, kraurosis vulvae?, tumor?]
      • Vagina (vagina), if necessary vaginal cytology to assess the hormonal status [blood?, fluor vaginalis / discharge?, color?, foetor?, mucus?, vaginal dryness (vaginal dryness)?; if pressed, if necessary incontinence problems (in about 60-70% of cases there is a stress incontinence (formerly: stress incontinence))]
      • Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) into the vagina (vagina), if necessary, taking a Pap smear (for early detection of cervical cancer) [blood?, ectopy (easily injured cylinder epithelium on the surface of the cervix)?, fluorine?, color?, foetor?, mucus?]
    • Palpation (bimanual; palpation with both hands) of the internal genital organs.
      • Cervix uteri (cervix) [dolence on movement?, cervical sliding, wiggling, venting pain?]
      • Uterus (uterus) [normal: anteflexed/angled forward, normal size, no tenderness, difficult to move?, fixed?, displaced?]
      • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tube (fallopian tube)). [Normal: free, [free?, palpable resistance in the small pelvis in the adnexal area?]
      • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free, pressure difference? Resistance?]
      • Pelvic walls [Normal: free, resistance?]
      • Douglas space (pocket-like bulge of peritoneum (abdominal wall) between rectum (rectum) posteriorly and uterus (uterus) anteriorly) [Normal: free, resistance?]
      • Digital rectal examination (DRU) [free?, mucus?, blood?, tumor?]
    • Examination of the mammae (breasts)
      • Inspection of mammae (breasts), right and left; nipple (breast), right and left, and skin [Normal: unremarkable, skin retractions (esp. when arms are raised)?, redness?, swelling?]
      • Palpation of the mammae, both supraclavicular pits (upper clavicle pits) and axillae (axillae) [Normal: unremarkable, resistance/tumor/nodes?, dolence?,orange peel?) secretion/blood secretion from the nipple? Lymph nodes palpable (palpable)?]]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.