The Vaginal Health Index Score (VHIS) serves as the primary qualitative assessment framework for objectively evaluating the success of laser treatments for vaginal atrophy. It functions by quantifying vaginal health across five specific dimensions: elasticity, fluid volume, pH levels, epithelial integrity, and moisture.
The VHIS is not merely a diagnostic label; it is a dynamic clinical tool used to establish baseline severity, drive real-time adjustments to treatment parameters, and verify the long-term restoration of tissue health.
The Five Pillars of VHIS Evaluation
Quantifying Tissue Health
The core function of VHIS is to standardize the assessment of the vaginal environment. By breaking down vaginal health into five distinct metrics—elasticity, fluid volume, pH, epithelial integrity, and moisture—clinicians can move beyond subjective observation.
Establishing a Clinical Baseline
Before any laser intervention begins, VHIS provides a snapshot of the initial condition. This allows practitioners to accurately categorize the severity of atrophy.
Measuring Physiological Change
The score is essential for tracking physiological improvements over time. It specifically monitors shifts such as the normalization of pH levels and the restoration of moisture, which indicate successful tissue regeneration.
Guiding Treatment Protocols
Customizing Energy Output
VHIS data directly informs the customization of laser parameters, such as Dot Power. A low VHIS score indicating fragile tissue or high sensitivity may necessitate lower power settings to ensure tolerability.
Adapting to Anatomical Sensitivity
Clinicians use assessment data to balance energy delivery between different anatomical zones. Higher power is often targeted at internal walls for remodeling, while lower power is applied to nerve-dense areas like the introitus.
Monitoring the Recovery Schedule
Laser treatment is typically a multi-stage process involving 1 to 3 sessions spaced six weeks apart. VHIS scores are reviewed at these intervals to confirm that tissue is self-repairing and collagen is regenerating effectively between sessions.
Understanding Clinical Trade-offs
Balancing Remodeling vs. Comfort
A critical trade-off in laser therapy is maximizing tissue remodeling while minimizing patient discomfort. While higher energy yields greater remodeling of the internal walls, it cannot be universally applied.
The Limits of Immediate Results
VHIS scores also highlight that tissue regeneration is cumulative rather than instantaneous. The thermal effects of the laser build up progressively, requiring a phased approach to steadily increase superficial cells and maintain a healthy acidic environment.
Making the Right Choice for Your Goal
To maximize the utility of the VHIS in a clinical setting, consider the following strategic applications:
- If your primary focus is Tissue Remodeling: Use VHIS to identify areas of higher epithelial integrity where Dot Power can be safely increased to maximize collagen regeneration.
- If your primary focus is Patient Tolerability: Rely on VHIS data to pinpoint highly sensitive or nerve-dense zones, lowering power settings to minimize discomfort without sacrificing overall efficacy.
By systematically applying VHIS criteria, clinicians ensure that laser therapy is not a "one-size-fits-all" procedure, but a tailored intervention that restores physiological balance safely.
Summary Table:
| VHIS Metric | Clinical Assessment Focus | Impact on Laser Protocol |
|---|---|---|
| Elasticity | Tissue flexibility and collagen | Determines pulse energy and depth |
| pH Levels | Acidity of the vaginal environment | Indicates physiological restoration |
| Moisture/Fluid | Glandular function and lubrication | Guides frequency of treatment sessions |
| Epithelial Integrity | Tissue fragility and sensitivity | Informs Dot Power and safety settings |
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References
- Scott Evan Eder. The Long Term Safety and Efficacy of the FemTouch for the Treatment of Vulvovaginal Atrophy in Postmenopausal Women [20M]. DOI: 10.1097/01.aog.0000559293.59565.66
This article is also based on technical information from Belislaser Knowledge Base .
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