Association between lower urinary tract symptoms and female sexual function: results from the GENitourinary syndrome of menopause in JApanese women (GENJA) study.

Background: Female sexual dysfunction (FSD) is highly prevalent in women with lower urinary tract symptoms (LUTS); however, few studies have assessed the association between specific LUTS and FSD.

Aim: To identify which specific LUTS are associated with which domains of female sexual function in Japanese women.

Methods: Data from 1337 sexually active women aged 40-79 years who participated in the GENitourinary syndrome of menopause in JApanese women (GENJA) study were analyzed. All participants answered web-based questionnaires including the Core Lower Urinary Tract Symptom Score, Female Sexual Function Index (FSFI), and Vulvovaginal Symptoms Questionnaire. We used multivariable regression to assess the association between LUTS and FSFI domain scores, adjusted for age, menstrual status, hormone therapy, hypertension, dyslipidemia, diabetes mellitus, and depression.

Outcomes: FSFI domain and total scores associated with LUTS.

Results: The mean age of participants was 54.0 ± 10.7 years. Women with LUTS were more likely to have lower total FSFI scores than those without, except for increased daytime urinary frequency. The multivariate analysis revealed that nocturia was associated with lower orgasm scores (coefficient: -0.23; 95% confidence interval [CI]: -0.45 to -0.01; P = .044), urgency with lower pain scores (coefficient: -0.62; CI: -1.09 to -0.14; P = .011), stress urinary incontinence (coefficient: -0.51; CI: -0.90 to -0.12; P = .011), and vaginal bulge/lump sensations (coefficient: -0.42; CI: -0.81 to -0.04; P = .031) with lower satisfaction scores.

Clinical implications: This study highlights the need to include routine assessments of sexual function in women with LUTS.

Strengths and limitations: This is the first study to comprehensively examine the association between specific LUTS and FSFI domain scores using validated questionnaires in a nationwide epidemiological survey among sexually active Japanese women. Limitations include non-random participant selection and reliance on self-reported data, which represent subjective symptoms.

Conclusion: LUTS, including nocturia, urgency, stress urinary incontinence, as well as vaginal bulge/lump sensations, were associated with FSD regardless of age, menstrual status, lifestyle-related diseases, or depression.