AMA Criteria for Permanent Impairment Associated with Vulval or Vaginal Disease

Disease of the vulva and/or vagina can result in permanent impairment that can be quantified using the AMA criteria.

Parameters:

(1) signs and symptoms

(2) sexual intercourse

(3) treatment

(4) capacity for vaginal delivery if premenopausal

Signs and symptoms of vulval or vaginal disorder:

(1) pain and/or tenderness

(2) vulvitis or vaginitis

(3) discharge

(4) loss of lubrication

(5) scarring, ulceration or stenosis

(6) loss of sensation

(7) atrophy

(8) hypertrophy

(9) dysplasia or neoplasia

(10) difficulties with sexual intercourse

Signs and Symptoms	Sexual Intercourse	Therapy	Vaginal Delivery	Impairment of the Whole Person
none	normal	none	adequate	0%
mild	possible	none or intermittent	adequate	0 - 15%
moderate	possible but with some difficulties	continuous	limited potential	16 – 25%
severe	not possible	ineffective	not possible	26 - 35%

where:

• If urinary or sexual dysfunction occur, then the degree of impairment needs to be combined with the vulval/vaginal impairment.

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