Chronic Vulvovaginitis in Women Older Than 50 Years: Analysis of a Prospective Database

Objective. This study aimed to examine differences in symptoms and diagnoses between women 50 years and younger and women older than 50 years who have chronic vulvovaginal complaints. Methods. New patients of the Drexel University Vaginitis Center with chronic vulvovaginal complaints were eligible. Participants underwent a standardized medical evaluation and completed detailed questionnaires. Data were analyzed using the t test, chi(2) test, and the Fisher exact test. Results. Subjects were 469 women aged 18 to 79 years. Subjects 50 years and younger (group A) were more likely to complain of vaginal itching and were less likely to complain of burning, irritation, or soreness (p <= .05 for all). Subjects older than 50 years (group B) were more likely to be diagnosed with atrophic vaginitis (p = .000), desquamative inflammatory vaginitis (DIV; p = .001), lichen planus (LP; p = .000), and lichen sclerosus (p = .000). Diagnosis of LS, LP, or DIV was associated with increased likelihood of multiparity and decreased likelihood of a history of systemic estrogen use. Conclusions. Postmenopausal women are more likely than premenopausal women to be diagnosed with DIV, LP, or LS. Both childbirth and estrogen nonuse were associated with the occurrence of these latter 3 conditions.