Genitourinary Syndrome of Menopause; Near-Infrared Spectroscopy; Chemometrics; Biomarkers; Vaginal Atrophy; Menopause.
Genitourinary syndrome of menopause (GSM) is characterized by estrogen deficiency-induced vulvovaginal and urinary symptoms but lacks objective diagnostic biomarkers. We investigated whether near-infrared (NIR) spectroscopy combined with multivariate chemometric analysis of cervicovaginal specimens could serve as a quantitative diagnostic tool for GSM. This case-control study included 81 postmenopausal women attending the Menopause Outpatient Clinic of Maternidade Escola Januário Cicco (MEJC/UFRN), comprising 50 women with GSM and 31 controls. Participants underwent clinical evaluation and cervicovaginal sample collection for NIR spectral analysis in diffuse reflectance mode over the 900–2600 nm range. Spectral data were preprocessed and analyzed using chemometric approaches, including principal component analysis (PCA) and supervised classification models (PLS-DA, PCA-LDA, GA-LDA, and SPA-LDA). Women with GSM exhibited significantly lower Vaginal Health Index (VHI) scores, particularly in the domains of elasticity, epithelial integrity, and mucosal moisture (all p < 0.05). NIR spectroscopy identified distinct spectral signatures in regions associated with O–H, C–H, and N–H vibrations, indicating alterations in tissue hydration, lipid composition, extracellular matrix integrity, and protein profiles. Principal component analysis demonstrated separation between GSM and control samples, confirming the presence of distinct molecular fingerprints. Among the classification models evaluated, PCA-LDA achieved 82% accuracy in independent validation, whereas GA-LDA and SPA-LDA attained 100% sensitivity, specificity, and overall accuracy. NIR spectroscopy combined with chemometric analysis enables objective and non-invasive discrimination of GSM, supporting a transition from subjective symptom assessment to quantitative molecular phenotyping. This approach holds promise for point-of-care diagnostics and therapeutic response monitoring, although further validation studies are warranted.