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FEMALE GENITOURINARY SYMPTOM QUESTIONNAIRE (CONFIDENTIAL)Vaginal and Labial Symptoms I have had difficult births My labia are larger than what I want I do not like the way my labia look My labia rub,
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To fill out the genitourinary syndrome of menopause, follow these steps:
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Begin by gathering the necessary information, such as medical history, symptoms experienced, and any medications being taken.
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Start by documenting the patient's demographics, including age, name, and contact information.
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Enter the date of the assessment and indicate the healthcare provider or facility conducting the assessment.
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Proceed to the genitourinary symptoms section and record the specific symptoms experienced by the patient, such as vaginal dryness, urinary incontinence, or painful intercourse.
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Assess the severity of each symptom and rate it on a scale, such as mild, moderate, or severe.
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Document any additional relevant information, such as the duration of the symptoms or any aggravating factors.
08
Move on to the genitourinary examination section and note any physical findings, such as vaginal atrophy or prolapse.
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Evaluate the impact of the symptoms on the patient's quality of life by completing the relevant questionnaire or rating scale.
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Include any additional comments, observations, or treatment recommendations.
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Review the completed form for accuracy and ensure all necessary sections are filled out.
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Sign and date the form to authenticate it and make a copy for the patient's medical records.

Who needs genitourinary syndrome of menopause?

01
Genitourinary syndrome of menopause may be needed by individuals who are experiencing the following symptoms:
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- Vaginal dryness
03
- Dyspareunia (painful intercourse)
04
- Urinary frequency, urgency, or incontinence
05
- Recurrent urinary tract infections
06
- Vulvovaginal atrophy
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- Itching or irritation in the genital area
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- Pain or discomfort during urination
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- Genital burning or discharge
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- Other genitourinary symptoms associated with menopause
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It is important to consult a healthcare provider for a thorough assessment and diagnosis before filling out the form.
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Genitourinary syndrome of menopause (GSM) refers to a range of symptoms related to the genitals and urinary tract that occur due to reduced estrogen levels during menopause. Symptoms may include vaginal dryness, irritation, painful intercourse, and urinary urgency.
There is no requirement to 'file' anything regarding genitourinary syndrome of menopause, as it is a medical condition rather than a formal submission or record with filing requirements. However, individuals experiencing GSM symptoms may need to discuss them with their healthcare provider.
There is no specific 'form' to fill out for genitourinary syndrome of menopause. Patients should record their symptoms and discuss them with their healthcare provider for proper diagnosis and management.
The purpose of understanding genitourinary syndrome of menopause is to identify and manage symptoms that affect quality of life, enabling affected individuals to seek appropriate treatment options to alleviate discomfort associated with menopause.
Information regarding the severity and frequency of symptoms, impact on daily life, and any related medical history should be reported to healthcare providers for an accurate assessment and treatment plan.
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