GYNECOLOGICAL ASPECTS OF PRIMARY SJOGRENS-SYNDROME

Female patients affected with Sjogren's Syndrome (SS) frequently descr ibe symptoms such as vaginal dryness and dyspareunia; however, only a few controlled studies have regarded clinical involvement of the femal e external genitalia. Objective: The present study was undertaken in o rder to: (1) Evaluate the involvement of external genitalia in a large number of female patients affected with primary SS (pSS) by semi-quan titative methods covering subjective symptoms and clinical evaluation. (2) Compare pSS patients with a matched healthy control group (pre- a nd post-menopausal women were separately studied). (3) Correlate the g ynaecological involvement with salivary and lacrimal abnormalities in pSS patients. Methods: We evaluated 36 patients with primary SS (18 pr e- and 18 post-menopausal women) and 43 healthy controls using a quest ionnaire regarding vulvar and vaginal dryness and a complete gynaecolo gical examination. Subsequently, three scores related to vulvar and ce rvical status plus a global score were obtained. In primary SS patient s, salivary and lacrimal involvement was also evaluated. Results: Dysp areunia was present in 61% and vaginal dryness in 55% of SS patients v ersus 39% and 33% of healthy controls. No significant differences rega rding gynaecological scores were found between SS patients and control s, in both pre- and post-menopausal women, nor correlation was observe d between gynaecological and lacrimal or salivary involvement. Conclus ions: Our data suggest that although SS patients frequently complain o f dyspareunia and vaginal dryness they do not greatly differ from heal thy subjects in regard to some major gynaecological aspects.