title: The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women.
abstract: BACKGROUND
  Urogenital symptoms affect up to half of women after menopause, but their impact on women's day-to-day functioning and wellbeing is poorly understood.
  
  
  METHODS
  Postmenopausal women aged 45 to 80 years reporting urogenital dryness, soreness, itching, or pain during sex were recruited to participate in in-depth focus groups to discuss the impact of their symptoms. Focus groups were homogenous with respect to race/ethnicity and stratified by age (for White or Black women) or language (for Latina women). Transcripts of sessions were analyzed according to grounded theory.
  
  
  RESULTS
  Six focus groups were conducted, involving 44 women (16 White, 14 Black, 14 Latina). Five domains of functioning and wellbeing affected by symptoms were identified: sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations. For some participants, symptoms primarily affected their ability to have and enjoy sex, as well as be responsive to their partners. For others, symptoms interfered with everyday activities, such as exercising, toileting, or sleeping. Participants regarded their symptoms as a sign that they were getting old or their body was deteriorating; women also associated symptoms with a loss of womanhood or sexuality. Additionally, participants reported feeling depressed, embarrassed, and frustrated about their symptoms, and expressed reluctance to discuss them with friends, family, or health care providers.
  
  
  CONCLUSIONS
  Urogenital symptoms can have a marked impact on sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations after menopause. Clinicians may need to question women actively about these symptoms, as many are reluctant to seek help for this problem.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA. ahuang@ucsfmed.org
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Janis
authors.initials: J
authors.lastname: Luft
authors.forename: Deborah
authors.initials: D
authors.lastname: Grady
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000375:Aging / Q000208:ethnology* / Q000502:physiology / Q000523:psychology; D044383:Black People / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000208:ethnology / Q000523:psychology; D005260:Female; D052776:Female Urogenital Diseases / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D017144:Focus Groups; D005836:Genitalia, Female / Q000502:physiology; D006630:Hispanic or Latino / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000208:ethnology* / Q000502:physiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D044469:Racial Groups / Q000208:ethnology / Q000523:psychology; D012725:Sexual Behavior / Q000208:ethnology* / Q000502:physiology / Q000523:psychology; D014553:Urinary Tract Physiological Phenomena; D044465:White People / Q000208:ethnology* / Q000523:psychology; D014930:Women