The objective: to evaluate the results of a comparative analysis of the clinical efficacy of various compositions, combination and pharmacological effects of drugs (antispasmodic, hormones, of plant origin) for symptoms of the lower urinary tract in women in the premenopausal period.Materials and methods. The efficacy of the treatment of 120 premenopausal women with symptoms of the lower urinary tract was studied. The complaints, uroflow metrics, sociological survey of results to identify the symptoms of menopausal syndrome by the MRS scale, as well as the level of anxiety by the S. Spielberg scale were evaluated as criteria for its assessment in the dynamics before and after 3, 6, 12 months. The data were statistically processed using Student’s and Fisher’s criteria.Results. There have been revealed the frequency and nature of complaints in women aged 40 plus, manifested in the form of urinary disorders, gynecological symptoms of menopausal syndrome. The results of treatment with the use of monotherapy with mirabegron, as well as in combination with menopausal hormone therapy (MHT) and herbal medicine, have been studied. There has been proven clinical advantage in treating women with genitourethral syndrome, using a combination of systemic MHT and symptomatic.Conclusions. Treatment of lower urinary tract symptoms in women of perimenopausal age with the presence of menopausal manifestations requires an integrated approach with the inclusion of systemic menopausal hormone therapy, among which objectively proven advantage of the drug, which includes levonorgestrel, as well as symptomatic therapy.