title: Self-reported urogenital symptoms in postmenopausal women: Women's Health Initiative.
abstract: OBJECTIVE
  To examine the prevalence and correlates of self-reported urogenital symptoms (dryness, irritation or itching, discharge, dysuria) among postmenopausal women aged 50-79.
  
  
  METHODS
  A cross-sectional analysis based on n=98,705 women enrolled in the US-based Women's Health Initiative observational study and clinical trials. Urogenital symptoms, symptom severity (mild, moderate, severe), and all covariates were self-reported through questionnaires at enrollment. Prevalence rates of each urogenital symptom were examined and logistic regression was used to identify potential correlates.
  
  
  RESULTS
  Prevalence rates for each symptom were: dryness, 27.0%; irritation or itching, 18.6%; discharge, 11.1%; and dysuria, 5.2%. Four factors were correlated with two or more symptoms: Hispanic ethnicity (adjusted odds ratio (AOR)=2.1-3.1 versus white women across all symptoms), obesity (AOR=2.2 severe discharge versus none, AOR=3.6 severe irritation/itching versus none), treated diabetes (pills or shots) compared to no diabetes (AOR=2.4 severe dysuria versus none, AOR=3.2 severe irritation/itching versus none), and vaginal cream HRT/ERT compared to those who never used HRT/ERT (AOR=4.4 severe dryness versus none, AOR=4.6 severe irritation/itching versus none). Factors not associated with the symptoms included sexual activity, age, years since menopause, current smoking, marital status, gravidity, and natural versus surgical menopause.
  
  
  CONCLUSIONS
  This is the first report to document urogenital symptoms by race/ethnicity among an exclusively postmenopausal population. We found an elevated prevalence of urogenital symptoms among women who are Hispanic, obese, and/or diabetic. Confirmation of our findings in these subgroups, and, if confirmed, analysis on why these populations are at greater risk, are areas for future research.
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22908, USA. lpastore@virginia.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Pastore
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Carter
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Hulka
authors.forename: Ellen
authors.initials: E
authors.lastname: Wells
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D009765:Obesity; D017698:Postmenopause; D015995:Prevalence; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016387:Women's Health