To investigate the main symptoms of female sexual dysfunction (FSD) and lower urinary tract symptoms associated with vulvovaginal atrophy (VVA) symptoms as the core symptoms of genitourinary syndrome of menopause.

Methods

We extracted the data of 4134 Japanese women aged 40–79 years who participated in the GENitourinary syndrome of menopause in JApanese women (GENJA) study. All participants responded to web-based questionnaires assessing their health situation, including the Vulvovaginal Symptoms Questionnaire, the Female Sexual Function Index (FSFI), and the Core Lower Urinary Tract Symptom Score. Multivariable regression and multivariable logistic regression analyses were applied to analyze the association between VVA symptoms and FSD, and between VVA symptoms and lower urinary tract symptoms.

Results

Multivariable regression analysis revealed that VVA symptoms were associated with lower scores for arousal, lubrication, orgasm, satisfaction, and pain domains in the FSFI in sexually active women (p < 0.01). Regression coefficients were higher for lubrication and pain domains than for the other domains. Multivariable logistic regression analysis revealed that women reporting VVA symptoms were more likely to have increased daytime urinary frequency, nocturia, urgency, slow stream, straining to void, feeling of incomplete emptying, bladder pain, and feeling a bulge/lump from or in the vagina (p < 0.05). Adjusted odds ratios were particularly high for straining to void, feeling of incomplete emptying, and bladder pain.

Conclusions

Vulvovaginal atrophy symptoms were significantly associated with decreased lubrication and dyspareunia in FSD, and urinary symptoms of straining to void, feeling of incomplete emptying, and bladder pain.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

REFERENCES

1Portman DJ, Gass ML; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. J Sex Med. 2014; 11: 2865–72.
10.1111/jsm.12686
PubMed Web of Science® Google Scholar
2Robinson D, Toozs-Hobson P, Cardozo L. The effect of hormones on the lower urinary tract. Menopause Int. 2013; 19: 155–62.
10.1177/1754045313511398
PubMed Google Scholar
3Nappi RE, Palacios S, Bruyniks N, Particco M, Panay N; EVES Study Investigators. The burden of vulvovaginal atrophy on women's daily living: implications on quality of life from a face-to-face real-life survey. Menopause. 2019; 26: 485–91.
10.1097/GME.0000000000001260
PubMed Web of Science® Google Scholar
4Simon JA, Kokot-Kierepa M, Goldstein J, Nappi RE. Vaginal health in the United States: results from the vaginal health: insights, views & attitudes survey. Menopause. 2013; 20: 1043–8.
10.1097/GME.0b013e318287342d
PubMed Web of Science® Google Scholar
5Mitchell CM, Waetjen LE. Genitourinary changes with aging. Obstet Gynecol Clin North Am. 2018; 45: 737–50.
10.1016/j.ogc.2018.07.010
PubMed Web of Science® Google Scholar
6Mili N, Paschou SA, Armeni A, Georgopoulos N, Goulis DG, Lambrinoudaki I. Genitourinary syndrome of menopause: a systematic review on prevalence and treatment. Menopause. 2021; 28: 706–16.
10.1097/GME.0000000000001752
PubMed Web of Science® Google Scholar
7Tomoe H, Ozaki Y, Yamamoto M, Kuwajima M, Ninomiya N, Sekiguchi Y, et al. Epidemiological study of genitourinary syndrome of menopause in Japan (GENJA study). Menopause. 2023; 30: 447–53.
10.1097/GME.0000000000002153
PubMed Web of Science® Google Scholar
8Erekson EA, Yip SO, Wedderburn TS, Martin DK, Li FY, Choi JN, et al. The Vulvovaginal Symptoms Questionnaire: a questionnaire for measuring vulvovaginal symptoms in postmenopausal women. Menopause. 2013; 20: 973–9.
10.1097/GME.0b013e318282600b
PubMed Web of Science® Google Scholar
9Tomoe H, Sekiguchi Y, Ozaki Y, Ninomiya N, Sato Y, Takahashi S. Linguistic validation of Japanese version of the Vulvovaginal Symptoms Questionnaire (VSQ). Nihon Hinyokika Gakkai Zasshi. 2021; 112: 173–8.
PubMed Google Scholar
10Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26: 191–208.
10.1080/009262300278597
CAS PubMed Web of Science® Google Scholar
11Takahashi M, Inokuchi T, Watanabe C, Saito T, Kai I. The Female Sexual Function Index (FSFI): development of a Japanese version. J Sex Med. 2011; 8: 2246–54.
10.1111/j.1743-6109.2011.02267.x
PubMed Web of Science® Google Scholar
12Homma Y, Yoshida M, Yamanishi T, Gotoh M. Core Lower Urinary Tract Symptom Score (CLSS) questionnaire: a reliable tool in the overall assessment of lower urinary tract symptoms. Int J Urol. 2008; 15: 816–20.
10.1111/j.1442-2042.2008.02121.x
CAS PubMed Web of Science® Google Scholar
13Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013; 48: 452–8.
10.1038/bmt.2012.244
CAS PubMed Web of Science® Google Scholar
14Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med. 2009; 6: 2133–42.
10.1111/j.1743-6109.2009.01335.x
CAS PubMed Web of Science® Google Scholar
15Calleja-Agius J, Brincat MP. The urogenital system and the menopause. Climacteric. 2015; 18: 18–22.
10.3109/13697137.2015.1078206
PubMed Web of Science® Google Scholar
16Griebling TL, Liao Z, Smith PG. Systemic and topical hormone therapies reduce vaginal innervation density in postmenopausal women. Menopause. 2012; 19: 630–5.
10.1097/gme.0b013e31823b8983
PubMed Web of Science® Google Scholar
17Nappi RE, Palacios S, Panay N, Particco M, Krychman ML. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric. 2016; 19: 188–97.
10.3109/13697137.2015.1107039
CAS PubMed Web of Science® Google Scholar
18Iosif CS, Bekassy Z. Prevalence of genito-urinary symptoms in the late menopause. Acta Obstet Gynecol Scand. 1984; 63: 257–60.
10.3109/00016348409155509
CAS PubMed Web of Science® Google Scholar
19Sturdee DW, Panay N; International Menopause Society Writing Group. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010; 13: 509–22.
10.3109/13697137.2010.522875
CAS PubMed Web of Science® Google Scholar
20Ohta H, Hatta M, Ota K, Yoshikata R, Salvatore S. Online survey of genital and urinary symptoms among Japanese women aged between 40 and 90 years. Climacteric. 2020; 23: 603–7.
10.1080/13697137.2020.1768236
CAS PubMed Web of Science® Google Scholar
21Erekson EA, Li FY, Martin DK, Fried TR. Vulvovaginal symptoms prevalence in postmenopausal women and relationship to other menopausal symptoms and pelvic floor disorders. Menopause. 2016; 23: 368–75.
10.1097/GME.0000000000000549
PubMed Web of Science® Google Scholar

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Volume30, Issue10

October 2023

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Female sexual dysfunction and lower urinary tract symptoms associated with vulvovaginal atrophy symptoms: Results of the GENJA study

Abstract

Objectives

Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

REFERENCES

Citing Literature

References

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Female sexual dysfunction and lower urinary tract symptoms associated with vulvovaginal atrophy symptoms: Results of the GENJA study

Abstract

Objectives

Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

REFERENCES

Citing Literature

References

Related

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