Vaginal dryness (VD) affects both pre- and postmenopausal women at any age. Since the hormonal regulation changes during the climacteric period are considered as being the main course of the VD, affected women prefer not to talk about the problem. However, the problem does exist, and unfortunately if any, relatively minor group in the population possesses the health literacy at sufficient level to understand that VD is a suboptimal health condition which carries a multi-factorial character. Thereby, some of the contributing factors are clearly preventable and, therefore, if treated properly, have a potential to milden the VD. Current chapter demonstrates specific signs and symptoms of Flammer syndrome in women suffering from vaginal dryness, although individualised patient profiles clearly discriminate between pre- and postmenopausal women regarding the subgroup-specific symptoms. Noteworthy, about 20% of the VD patients involved in the study notify a delayed or even impaired wound healing observed for themselves over a couple of years. Optimising modifiable risk factors accompanying FS phenotype at the level of primary prevention is strongly recommended. Individualised patient profiles provide important information for VD mitigating measures tailored to the person. Further, future projects should essentially deal with the complexity of vulvar-vaginal dryness as part of the Sicca syndrome in individuals with FS phenotype, in order to prevent genital female cancers which may occur at any age. In contrast to the human papilloma virus as possible trigger of the disease, the role of the vulvar-vaginal dryness as an important risk factor is strongly underestimated in currently applied diagnostic and treatment approaches.

Centre of Obstetrics Gynaecology and Gynaecologic Oncology DonauIsar Klinikum Deggendorf Dingolfing Landau Germany

Department of Histology and Embryology and Biomedical Center Faculty of Medicine in Pilsen Charles University Prague Czech Republic 5Department of Neurology University Hospital Pilsen Pilsen Czech Republic

Department of Obstetrics and Gynaecology Jessenius Faculty of Medicine Martin University Hospital Martin Slovak Republic

Department of Obstetrics and Gynaecology Jessenius Faculty of Medicine Martin University Hospital Martin Slovak Republic 7Division of Oncology Biomedical Centre Martin Jessenius Faculty of Medicine Comenius University in Bratislava Bratislava Slovak Republic

Gynaecologic Department Clinical Hospital Pheophania Kyiv Ukraine

Radiological clinic UKB Rheinische Friedrich Wilhelms University of Bonn Sigmund Freud Str 25 53105 Bonn Germany 10Breast Cancer Research Centre UKB Rheinische Friedrich Wilhelms University of Bonn Bonn Germany 11Centre for Integrated Oncology UKB Cologne Bonn Rheinische Friedrich Wilhelms University of Bonn Bonn Germany

Ultrasound Department Clinical Hospital Pheophania Kyiv Ukraine 3Zabolotny Institute of Microbiology and Virology National Academy of Sciences of Ukraine Kyiv Ukraine

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