Vulvovaginal Atrophy Questionnaire (VVAQ): Psychometric Validation of a Novel PROM

Inclusion Criteria: * Female * Age \> 45 years * Menopausal, defined as: \> 1 year since last menses (with a uterus, without progestin- releasing IUD, without prior endometrial ablation), or \> 6 months since bilateral oophorectomy * Pelvic exam completed as part of visit * Able to communicate in English Exclusion Criteria: * Chronic, bothersome vaginal symptoms before menopause (e.g. vulvar or vaginal pain, dryness, itching, discharge, discomfort with sexual activity) * History of chronic urogenital condition (vulvar, vaginal, urinary), involving pain, pruritis, discharge, or inflammation, unrelated to menopausal estrogen deficiency * History of lichen sclerosis or lichen planus * History of vulvar, vaginal or cervical cancer * Prior vulvar or vaginal surgery (office biopsy allowed) * Active major medical illness (e.g., unstable heart disease, untreated psychiatric disorder) that might interfere with the ability to participate in the study * Undiagnosed vaginal bleeding * Exam findings consistent with a urogenital condition unrelated to menopausal estrogen deficiency (e.g. yeast or BV vaginitis, vulvodynia, vulvo-vestibulitis, lichen sclerosis, lichen planus)