Lower urinary tract symptoms and their relation to vaginal atrophy in women across the menopausal age span. Results from the ANGEL multicentre observational study

Objectives: To evaluate the relation between lower urinary tract symptoms (LUTS) and vaginal atrophy (VA) in 518 women across the menopausal age span (40–55 years of age). Study Design: Multicentre, cross-sectional study. Main Outcome Measures: VA was evaluated by the contemporaneous presence of a pH > 5, vaginal dryness and at least one objective sign of VA (mucosal pallor, dryness, thinning, fragility or with petechiae)., LUTS were evaluated by the Urogenital Distress Inventory (UDI-6). Sexuality was evaluated by the Female Sexual Function Index (FSFI). Results: Women were categorized by age: group 1, 40–45 years; group 2, 46–48 years; group 3, 49–51 years; and group 4, 52–55 years. Similar rates of recurrent urinary infection (RUI) were present in different age groups. RUI rate was related to VA (OR 1.703, 95 %CI 1.037, 2.799) and dyspareunia (OR 2.060, 95 %CI 1.199, 3.539). The rates of LUTS were also similar in the different age groups or in the presence of VA. The LUTS rate was related to dyspareunia (OR 1.971, 95 %CI 1.020, 3.808). Distress from LUTS was similar among different age groups and in the presence of VA. It was related to RUI (CR 7.187, 95 %CI 3.532, 10.841; p < 0.0001) and being an ex-smoker (CR 5.189, 95 %CI 1.425. 6.952; p < 0.007), and was inversely related to FSFI score (CR -0.314, 95 %CI -0.478, -0.149; p < 0.0002), Conclusions: In women across the menopausal age span, RUI, but not LUTS, is related to VA. The presence of LUTS is related to dyspareunia, and distress from LUTS is inversely related to sexuality. These results obtained in women across the menopausal age span are not applicable to older postmenopausal women.