Vulvovaginal Symptoms Questionnaire (VSQ)

Original Editor - Khloud Shreif

Top Contributors - Khloud Shreif  

Objective[edit | edit source]

The Vulvovaginal Symptoms Questionnaire (VSQ) is a 21-item written questionnaire used in medical and research settings for the assessment and evaluation of symptoms related to the vulva and vagina in women. It consists of a series of questions designed to assess various vulvovaginal symptoms and their impact on a woman's life, these questions cover symptoms such as itching, burning, pain, discharge, and discomfort in the vulva and vagina, as well as questions about emotions, life-impact, and sexual impact to help for better understanding and managing conditions affecting the female genital area[1].

VSQ is used to gather comprehensive information about the severity, frequency, and duration of the symptoms and with their impact on sexual function, daily activities, and emotional well-being.

Intended Population[edit | edit source]

The questionnaire is used for women with various gynecological conditions, such as; vulvovaginal candidiasis (vaginal yeast infection), bacterial vaginosis, vulvodynia (chronic vulvar pain), vaginal atrophy, and other inflammatory or infectious conditions (vulvar dermatitis or lichen sclerosus[2])[3].

Method of Use[edit | edit source]

The Vulvovaginal Symptoms Questionnaire (VSQ) consists of 21 items, the answer for each item will be yes or no, all women will have to answer a scale for their symptoms in the last week, and the first 17 questions will be answered by each woman, but the last 4 questions will be answered by just who is sexually active. The items are as following[1]:


  1. vulva itching?
  2. Do you feel your vulva burning or stinging?
  3. Are you experiencing vulva pain?
  4. Is your vulva irritated?
  5. Do you have vulva dryness?
  6. Are you experiencing any discharge from your vulva or vagina?
  7. Do you notice any odor from your vulva or vagina? Emotions
  8. Do you worry about your vulvar symptoms? (For example, that it will spread, get worse, scar, etc).
  9. How do you feel about the appearance of your vulva?
  10. Do you feel frustrated about your vulvar symptoms?
  11. Are you embarrassed about your vulvar symptoms?
  12. How have your vulvar symptoms affected your interactions with others?
  13. Do your vulvar symptoms affect your desire to be with people? Life- impact
  14. Have your vulvar symptoms made it hard to show affection?
  15. How do your vulvar symptoms affect your daily activities?
  16. Do your vulvar symptoms affect your desire to be intimate?
  17. Are you currently sexually active with a partner? If No→ Thank you. You are done with this questionnaire. Yes→ Please proceed with the next 4 questions sexual-impact
  1. How have your vulvar symptoms affected your sexual relationships?
  2. Do your vulvar symptoms cause pain during sexual activity?
  3. Do your vulvar symptoms cause dryness during sexual activity?
  4. Do your vulvar symptoms cause bleeding during sexual activity?

Evidence[edit | edit source]

The VSQ's validity was assessed by comparing it to other validated gynecologic questionnaires and physical exam findings since there is no established gold standard for vulvovaginal symptom measurement. There were fair correlations found between the VSQ and questionnaires for other gynecologic diseases (PFDI-20 and PFIQ-7) and for sexual function in pelvic floor disorders (PISQ-12). However, a low correlation was observed between the VSQ and the FSFI.

Reliability[edit | edit source]

VSQ demonstrated moderate test-retest reliability with a value greater than 0.41[1].

A Spanish-language version of VSQ demonstrated the scale was a reliable tool for the assessment of both vulvar and vaginal symptoms in postmenopausal women[4].

ICC values were 0.75, 0.60, 0.55, and 0.65, for symptoms, emotions, life impact, and sexual impact respectively[1], and it was 0.89 for Persian version[5], and 0.80 for Brazilian Portuguese[6].

Validity[edit | edit source]

VSQ demonstrated a construct validity with fair correlation around (0.41 to 0.45) with the PFDI-20 and PFIQ-7 questionnaires[7][1].

Miscellaneous[edit | edit source]

There was a negative correlation (-0.16) between the VSQ and the FSFI (a questionnaire focusing on different aspects of sexual function)[1]. Brazilian Portuguese[6] demonstrated a weak correlation with the pelvic domain of the Pelvic Floor Disorders Inventory, the pelvic organ prolapse domain of the Pelvic Floor Impact Questionnaire, and pain, vitality, and the social aspect domains of 36-Item Short-Form Survey.

However VSQ proves to be a reliable tool for evaluating vulvovaginal symptoms in women with VLS and VLP, it may not fully appropriate for this patient population, and modifications or additional domains may be necessary to effectively measure the impact of treatment on life impact and sexual function in this specific group of patients[2].

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Erekson EA, Yip SO, Wedderburn TS, Martin DK, Li FY, Choi JN, Kenton KS, Fried TR. The VSQ: a questionnaire to measure vulvovaginal symptoms in postmenopausal women. Menopause (New York, NY). 2013 Sep;20(9):973.
  2. 2.0 2.1 Kohn J. 088 Validation of the Vulvovaginal Symptoms Questionnaire in Women with Vulvar Dermatoses to Assess Sexual Function & Quality of Life. The Journal of Sexual Medicine. 2019 Jun 1;16(6):S33.
  3. Bachkangi P, Malik S. Assessment of Vulvovaginal Atrophy Symptoms in Women Attending Gynaecology Clinics: A Service Evaluation Project. Gynecol Reprod Health. 2023; 7 (1): 1-6. Correspondence: Panayoti Bachkangi, United Hospitals of Derby and Burton, Burton-upon-Trent, UK. Received. 2022 Dec;30.
  4. Fernández-Alonso AM, Alcaide-Torres J, Fernández-Alonso IM, Chedraui P, Pérez-López FR. Application of the 21-item Vulvovaginal Symptoms Questionnaire in postmenopausal Spanish women. Menopause. 2017 Nov 1;24(11):1295-301.
  5. Shaabani N, Parvizi MM, Bagheri Z, Saki N, Shahsavar Z, Heydarirad G, Tansaz M. Psychometric properties of a Persian version of the Vulvovaginal Symptoms Questionnaire for measuring vulvovaginal symptoms in postmenopausal women. Menopause. 2023 Mar 1;30(3):323-8.
  6. 6.0 6.1 Alem ME, Chaves TC, de Figueiredo VB, Beleza AC, Ferreira CH, da Silva JB, Driusso P. Cross-cultural adaptation and psychometric evaluation of the Brazilian Portuguese version of the Vulvovaginal Symptoms Questionnaire. Menopause. 2022 Sep 23;29(9):1055-61.
  7. Tekin AB, Yassa M, Kalkan U, Sargin MA, Keskin I, Usta S, Budak D, Buran AM, Tug N. Validation of the Vulvovaginal Symptom Questionnaire in Turkish women with genitourinary syndrome of menopause. Menopause. 2022 Mar 1;29(3):327-34.