الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
According to Goldstein et al. (2007) Vaginal atrophy is a common medical condition that is linked to menopause. This condition is associated with sexual dysfunction disorders women with vaginal atrophy are nearly four times more likely to experience sexual function disorders compared with those women with normal vaginal tissue.Vaginal atrophy impact on sexuality and intercourse, has been shown to affect urinary function and may even impact activities of daily living, including sitting and exercise. These broad-range effects have been reported to cause significant emotional distress and reduced quality of life in postmenopausal women (The North American Menopause Society, 2006).Menopause is often associated with vulvar and vaginal changes condition, there is loss of collagen, adipose tissue, and capacity for water retention in the vulva, resulting in thinning of the epithelial surface; loss of the protective covering of the clitoral glans, causing in an increased vulnerability to irritation; thinning of the vaginal mucosa; loss of vaginal rugal folds; altered vaginal maturation reduced normal lactobacilli flora; changes in pH; and decreased vaginal blood flow and secretions normally associated with sexual arousal (Shulman , Portman, 2008).Lindau , (2008)pointed that, menopause is characterized by a decline in ovarian function and a decrease in systemic estrogen levels.1 Menopause can be natural, surgically induced, chemically induced, or due to premature ovarian failure. Estrogen plays a critical role in maintaining the structure and function of the female urogenital system, including the vulva, vagina, bladder, urethra, pelvic floor, and endopelvic fascia.Vaginal atrophy is one of the most common manifestations of estrogen deprivation.Vaginal and vulvar irritation, dryness, itching, and burning; leukorrhea; and dyspareunia are the commonly reported symptoms of urogenital atrophy, which result in tremendous discomfort and decreased libido and quality of life (Simon , 2009).Reassurance is resorted to when the women need no treatment. A sympathetic talk with the menopausal women may be sufficient to relieve most of her symptoms. She should understand that menopause is a physiological period of her life marking the natural end of reproductively. changes in lifestyle can help to reduce the severity of menopausal symptoms . Diet and exercise are two very important aspects of these lifestyle changes (Bachmann , 2009).The current study has been conducted in two settings in Gharbia Governorate El- Mahalla El-Kubra center Hospital, Maternal & childhood Center Reait tefl thany.in El MehallaEl Kobra.The data collection instruments included:Structured Interviewing questionnaire this included 6 main parts a) Personal and demographic data such as age, marital status, educational level, household income and employment status occupation, b) obstetric history such as number of pregnancies, deliveries, and number of abortions. c) Medical history such as history of anemia, heart disease and liver diseases, d) Family history, e) present complaints related to menopause such as hot flashes, osteoporoses and, f) The health seeking behavior and available health care facilitiesPart 2:
Interviewing questionnaire: this included 3 parts (psychological, social and physical. To assess relationship between vaginal atrophy & its impact on quality of life it had 3 score level (poor, good, very good) (Endicott J et al, 1993).The study was began from the first of January to the end of September 2014 where took 9 month about 2 days per week (Saturday & Sunday) about 6 month in each hospital. The time consumed with each women 25-35 minutes.The important finding of this study was the relation between educational level and starting age of menopause, it has been found that there was an insignificant relation between them.In this study, it has been found that menopausal women have detailed negative effects of vaginal atrophy on their quality of life Concerning vaginal discomfort it has been found that, more than 50 % of menopausal women have vaginal discomfort.Concerning the psychological symptoms, it has been found that depression is the most frequent identified symptom among menopausal women.In the other hand , it has been found that vaginal atrophy can significantly impair the quality of life (QOL) of postmenopausal women and could be underdiagnosed.Regarding the more frequent symptoms during menopause, it was found that , psychological symptoms were the most common according to Lyndaker, (2004) who studied the influence of age on symptoms of menopause, reportted that more psychological and general somaticsymptoms are found among the participants such as sleeplessness, moodiness, depression, and poor concentration.Based on the finding of the current study, it has been concluded that:- 1. There was statistical difference between vaginal atrophy and quality of life (psychological) . 2. Also the results showed that the majority of the women in the studied sample suffered from sexual, physical, psychological and social problems as reflection of vaginal atrophy. 3. The majority of the women in the studied sample suffer from negative impact of vaginal atrophy on their physical, social life.
4-More than half of the study sample suffer from negative impact of Vaginal atrophy on sexual process.Based on the findings of the present study, the following recommendations are suggested:1. Women sexual rights should be situated as an important in all aspects of the women reproductive health in Egypt2. Premarital counseling about sexual problems play an important role before marriage.3. There should be specialized nurses to guide and teach the women regarding how to deal with sexual problems.4. Open and accurate communication regarding sexual issues between parents and their children is important to help them to develop healthy sexual relationships.5. Sexual health consultations emphasized as part of the health services.