Genitourinary syndrome of menopause in Chinese perimenopausal and postmenopausal women

Abstract

Objective

The aim of this study was to investigate genitourinary syndrome of menopause (GSM) in a large cohort, analyzing the dependency on age and menopausal status and possible differences between non-hysterectomized and hysterectomized women.

Methods

Data were assessed by validated questionnaires, collected over 2 years for all eligible women attending our ‘Menopause Clinic’ from 31 Chinese provinces. Simple and unconditional logistic regression analysis was used with adjustments by all analyzed factors.

Results

A total of 4063 women (mean age 50.53 ± 6.57 years), 2107 perimenopausal and 1956 postmenopausal, were included. Almost all GSM symptoms were more frequent and severe in postmenopausal women. GSM was more frequent in hysterectomized women compared to non-hysterectomized women. Independent of menopausal status, low sexual interest (92.78%), urinary incontinence (91.65%) and vaginal dryness (91.60%) were the top three GSM symptoms. Most severe were low sexual interest (21.01%), vaginal pain (20.10%) and decreased sexual pleasure (17.13%). Prevalence and severity of GSM were not related to age, but were related to menopausal status and increased with time since menopause.

Conclusions

Within 2 years, more than 4000 women with GSM traveled from all over China to our specialized clinic, indicating the great importance of GSM. Hysterectomy can increase the risk of GSM, and GSM symptoms increase from perimenopause to postmenopause and with an increase of time since menopause, pointing to the dependency on the loss of ovarian function.

摘要

目的：本研究的目的是在大队列中调查绝经泌尿生殖系统综合征（GSM）情况, 分析其与年龄和绝经状态的相关性, 以及切除子宫和未切除子宫女性之间可能的差异。

方法：通过有效的调查问卷进行数据评估, 纳入了来自中国31个省、市、自治区, 超过两年在我们“绝经门诊”就诊的且符合条件的女性。采用简单和无条件logistic回归分析, 并根据各分析因素进行调整。

结果：共纳入了4063名女性（平均年龄50.53±6.57岁）, 2107名围绝经期女性和1956名绝经后妇女。在几乎所有的绝经后患者中GSM症状都更为严重和频繁。与未切除子宫的女性相比, 切除子宫的女性更容易出现GSM。性快感低（92.78%）、尿失禁（91.65%）和阴道干涩（91.6%）是独立于绝经状态外的GSM三大症状。最严重的是性欲低（21.01%）、阴道疼痛（20.10%）和性快感降低（17.13%）。GSM的患病率和严重程度与年龄无关, 但与绝经状态有关, 并随着绝经后的时间增加而增加。

结论：2年内, 全国有4000多名GSM女性患者来我科就诊, 表明GSM的重要性。子宫切除术会增加GSM的风险, 且GSM症状从围绝经期到绝经后均会增加, 且随着绝经后时间的增加而增加, 表明对卵巢功能的丧失有依赖性。

Keywords:

• Genitourinary syndrome of menopause
• perimenopause
• postmenopause
• risk factors

Acknowledgements

This study received statistical support from Xingming Li, a statistical expert from Capital Medical University, Beijing, China.

Potential conflict of interest

The authors report that they have no conflicts of interest.

Data availability statement

Because this cohort study is ongoing, the data are not available to readers.

Additional information

Funding

This study was supported by Beijing Municipal Health Commission [No. (2017)35]; Beijing Municipal Administration of Hospitals’ Ascent Plan [No. DFL20181401]; Beijing Municipality Health Technology High-level Talent [No. 2014-2-016].