Menopause: The Journal of The North American Menopause Society Vol. 21, No. 2, pp. 182/187 DOI: 10.1097/gme.0b013e3182937966 * 2013 by The North American Menopause Society Frequency and determinants of urogenital symptoms in postmenopausal Islamic women Yunus Aydin, MD, 1 Hikmet Hassa, MD, 1 Tufan Oge, MD, 1 Omer Tarik Yalcin, MD, 1 and Fezan yahin Mutlu, PhD 2 Abstract Objective: The objective of this study was to evaluate the frequency of genitourinary symptoms and their re- lationships with several factors in a large cohort of postmenopausal women in Turkey. Methods: We performed a cross-sectional study to review genitourinary complaints among 1,328 postmenopausal women; 1,071 of these women were enrolled in the study. They were questioned about their vaginal and urinary symptoms, and the relationships between these symptoms and their demographic characteristics were evaluated. Results: The most common vaginal and urinary symptoms were dryness (n = 358; 33.4%) and nocturia (n = 421; 39.3%), respectively. Cigarette smoking and regular exercise were not associated with any vaginal symptoms (P 9 0.05), with the exception of an association between regular exercise and vaginal dryness (P = 0.026). Nocturia was more common in women older than 60 years (P = 0.001) and in obese women (P = 0.013). Based on multiple binary logistic regression analysis, lower educational status (primary school vs secondary school or higher) and higher parity were the factors most significantly associated with the appearance of at least three vaginal symptoms. Lower educational status was associated with vaginal pain (P = 0.002; odds ratio [OR], 1.75), itching (P G 0.001; OR, 1.23), and discharge (P = 0.011; OR, 1.46). Higher parity was associated with vaginal itching (P G 0.001; OR, 1.23), dis- charge (P = 0.07; OR, 1.18), and burning (P = 0.012; OR, 1.16). Body mass index (BMI) was the only factor that was significantly associated with the appearance of at least three urinary symptoms, with each one-unit increase in BMI increasing the risk of urgency (P G 0.001; OR, 1.06), nocturia (P G 0.001; OR, 1.06), and frequency (P = 0.009; OR, 1.04). Conclusions: We identify associations between the frequency of genitourinary complaints and educational status, parity, and BMI. There is no association between regular exercise and urogenital symptoms. However, prospective studies are needed to evaluate the effects of regular exercise on urogenital symptoms. When examining postmeno- pausal women with risk factors for urinary and vaginal symptoms, clinicians should evaluate these symptoms more thoroughly to facilitate earlier treatment. Key Words: Exercise Y Genitourinary symptoms Y Lifestyle Y Menopause Y Urinary symptoms Y Vaginal symptoms. E strogen deprivation can cause vaginal atrophy symp- toms and vasomotor symptoms, which critically dimin- ish quality of life in postmenopausal women. Although climacteric symptoms, particularly vasomotor symptoms, may be transient, atrophic symptoms affecting the vagina and lower urinary tract are often progressive and frequently require treat- ment. 1 Despite the high prevalence and diversity of urogeni- tal symptoms, only 20% to 25% of symptomatic women seek medical help; most women avoid complaining about vaginal and urinary symptoms during their postmenopausal years, which may be attributable to cultural values and the acceptance of these symptoms as a normal aspect of aging. 2,3 Studies evaluating the frequency of urogenital symptoms and the factors associated with such symptoms face obstacles because of the embarrassment experienced by women when discussing these issues in the context of different cultures, par- ticularly in Islamic societies. Although several multinatio- nal studies have evaluated vaginal and urologic symptoms in postmenopausal women, 3<7 only a few such studies have been conducted in Turkey. 8<11 Moreover, with the exception of mul- tinational studies, many studies have included limited numbers of participants. With the goal of overcoming this research deficit, we aimed to determine the frequency of genitourinary symptoms and their associated factors in a large cohort of postmenopausal women in Turkey. To the best of our knowledge, this study includes one of the largest numbers of participants from a single institute in the English literature and in Turkey. Received January 9, 2013; revised and accepted March 21, 2013. From the Departments of 1 Obstetrics and Gynecology and 2 Biostatistics, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey. The authors alone are responsible for the content and drafting of this manuscript. Funding/support: None. Financial disclosure/conflicts of interest: None reported. Address correspondence to: Tufan Oge, MD, Department of Obstetrics and Gynecology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26100, Turkey. E-mail: tufanoge@gmail.com 182 Menopause, Vol. 21, No. 2, 2014 Copyright © 2014 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.