Urogenital Symptoms and Resulting Discomfort in Non-Institutionalized Dutch Women Aged 50–75 Years

Abstract

The aim of this study was to determine the prevalence of urogenital symptoms in non-institutionalized Dutch women aged 50-75 years, and the degree of discomfort suffered as a result. A questionnaire was sent to 2157 women, a sample representative of the female population aged 50-75 years with respect to age, marital status, level of education and menopausal age. The usable response was 81.6% (n = 1761). The overall prevalence of vaginal dryness, soreness and dyspareunia was 27%. The prevalence of micturition symptoms, urinary incontinence and recurrent urinary tract infection was 36%. The prevalence estimates for vaginal dryness and urinary incontinence showed a linear decrease with increasing age. Almost half of the symptomatic women reported moderate to severe discomfort. One-third of those affected received medical care. Previous hysterectomy had no effect on the reported prevalence estimates. Hysterectomized women reported moderate to severe complaints more often than non-hysterectomized ones. There were no significant differences in prevalence estimates between former and current smokers and non-smokers.

The epidemiology of female urinary incontinence

“…Symptoms recur more severely with each subsequent pregnancy and ultimately may result in permanent disability. The results of the longitudinal studies performed during pregnancy and after childbirth suggest that pregnancy may weaken or cause disruption of the pelvic musculofascial structures which support the continence mechanism or may uncover a genetic predisposition to incontinence [25,42,50,53,79]. Incontinence during pregnancy or immediately after childbirth was found to be highly correlated with urinary incontinence in later life [24,55,82].…”

“…The authors concluded that mixed incontinence may be over-reported in epidemiological surveys and a larger majority than hitherto reported may have pure stress incontinence. A few studies have shown that after menopause the relative proportion of urge incontinence increases with age, whereas the percentage of stress incontinence shows a slight but definite decrease [5,36,62,79,86].…”

“…About 14-20% of all affected women, i.e. $6-10% of the adult female population, suffer from clinically significant incontinence [33,39,55,57,79,86]. Only one-third of the women with regular incontinence felt the need for medical care [36,62,79].…”

“…It is generally thought that prevalence estimates for urogenital symptoms and urinary incontinence increase with increasing age. However, studies comparing different age groups in relation to age at menopause have shown that after the menopause prevalence rates of UI actually decrease until the age of 70-74 [8,28,47,62,77,79,86]. A few studies carried out in postmenopausal women suggest a causal relationship between menopause and the onset of UI [13,45,62].…”

“…A few studies carried out in postmenopausal women suggest a causal relationship between menopause and the onset of UI [13,45,62]. Other investigators failed to confirm these conclusions [23,47,77,79]. At menopause, specific changes in the paraurethral connective tissue take place.…”