Dose the patient being treated have any of the following conditions?

• Under 18 years old.

• Very severe pain during sexual intercourse, or if the condition is very severe.

• Irritation or discomfort that is not only of the vagina, but is being felt in other parts of the body as well.

• Dryness of the vagina that persists after trying an over the counter product such as a lubricant.

• Vaginal bleeding.


Yes

No






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