Investigation And Risk Factors Analysis Of Genitourinary Syndrome Of Menopause

Objective:By means of questionnaire and laboratory analysis,getting the acquaintance of current situation of the GSM(genitourinary syndrome of menopause)in Nanjing province and explore the main influencing factors of GSM.In order to further formulate the disease intervention measures and prevention strategies for present stage,and to provide the data basis for rational distribution of health services.Methods:From December 2016 to April 2018,a questionnaire survey was conducted among the menopausal women visiting the physical examination and gynecology departments of Zhongda Hospital.And gynecologic examinations,vaginal atrophy symptoms and signs score,vaginal microecology,vaginal exfoliated cells were examined the same time.A self-made questionnaire was used to investigate the status of GSM,including general situation,history of past diseases,personal history,menstrual history,marriage and family history,and the symptoms of genitourinary tract.All the respondents were voluntarily participated in and signed informed consent.Finally,the SPSS22.0 software was used to analyze the content of the questionnaire and the results of the examination.Results:1.General situation:a total of 200 questionnaires were issued in this study and112 were recovered.The response rate was 56%.The average age was 64.27+9.72years old,and the average menopause years was 13.66+10.41 years.2.The incidence of genitourinary tract symptoms in postmenopause women:64(57.14%)of the 112 participants were conscious of reproductive tract symptoms,23.2%(26/112)had lower genital pain,20.5%(23/112)spontaneous burning,20.5%(23/112)pruritus,30.4%(34/112)consciously dry,39.3%(44/112)with superficial intercourse pain,37.5%(42/112)Deep intercourse pain.And 79(70.5%)participants had urinary system symptoms,37.5%(42/112)urinary frequency,50%(56/112)urination,42.9%(48/112)nocturnal urine,31.2%(35/112)conscious bladder emptying incomplete,43.8%(49/112)conscious bladder emptying.The correlation analysis of urinary system symptoms and reproductive system symptoms in postmenopause women showed R(110)=0.23,P<0.05..3.The vagina atrophy symptoms and signs score:the average of score were 8.29+5.22.,The average symptom score was lower than the sign score.Matched?~2 test showed that postmenopausal women in the study were more likely to have signs of vaginal atrophy than symptoms(p<0.05).4.The vaginal microecology of menopausal women:10.71%(12/112)experienced normal vaginal microecology,89.29%(100/112)experienced maladjustment,the normal rate of the groups of?60 years old,61-70 years old,>70years old was 17.50%(7/40),9.52%(4/42)and 3.33%(1/30).5.The relationship between vagina atrophy symptoms and signs score and menarche:the menarche age of people whose score?15 greater than ones whose score<15 with statistical significance(P<0.05).The score of ones whose average menarche age<15 years old was 6.98+4.81,the?15 years old group was 9.98+5.28,t(110)=-3.13,P<0.05.The scores of ones whose average menarche age?15years old got higher score than ones whose menarche age<15 years old.6.The influencing factors of vagina atrophy symptoms and signs score:the correlation analysis of score and factors showed that age R(110)=0.47,P<0.05,menarche age R(110)=0.40,P<0.05,years of menopause R(110)=0.46,P<0.05,vagina pH R(110)=0.83,P<0.05.Vaginal exfoliated cell maturation values(MV)r(110)=-0.96,P<0.05.7.The influencing factors of urinary symptoms:smoking,hypertension,and diabetes history were different between women with urinary symptoms and normal ones,P<0.05.8.Multivariate linear regression of symptoms and signs score,model 1:score=22.02-0.33*MV+0.62 x PH,R=0.93.Adjust the model according to clinical practice,Model 2:score=-15.59+3.37 x PH+0.08 x age,R=0.71.Conclusions:1.The incidence of GSM in postmenopausal population was high,but wemon in postmenopausal period had limited consciousness of GSM.2.The occurrence of postmenopausal reproductive system symptoms is related to age,menarche age,years of menopause,vaginal PH and vaginal exfoliated cell MV.3.Postmenopausal urinary system symptoms were associated with smoking,hypertension and diabetes history.4.Postmenopausal women in the study were more likely to have signs of vaginal atrophy than symptoms,and regular physical examination was helpful for the diagnosis of GSM in postmenopausal women.Age,vaginal PH are important for screening asymptomatic or mild GSM.