Menopausal stages and overactive bladder symptoms in middle-aged women: A cross-sectional study

Objective: To examine the prevalence of overactive bladder (OAB) according to menopausal stages in middle-aged women. Design: Cross-sectional study. Setting: Total Healthcare Center in South Korea. Population: Middle-aged Korean women (n=3469, mean age, 49.5 +/- 2.9 years). Methods: Menopausal stages were defined according to the Stages of Reproductive Aging Workshop +10 criteria, and menopausal symptoms were assessed using the Korean version of Menopause-Specific Quality of Life (MENQOL). Logistic regression models were used to estimate prevalence ratios with 95% confidence intervals for OAB according to menopausal stage and to assess the associations with menopausal symptoms. Main Outcome Measures: OAB symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS). Results: The prevalence of OAB increased with menopausal stage; however, the multivariable-adjusted prevalence ratios for women in menopausal transition and postmenopausal stage were insignificant (p(trend) = 0.160) compared to those for premenopausal women. Among individual OAB symptoms, the multivariable-adjusted prevalence ratios for nocturia increased with menopausal stage in a dose-response manner (p(trend) = 0.005 for 1 time/day; p(trend) < 0.001 for >= 2 times/day). The association between menopausal stages and nocturia occurring >= 2 times/day was evident in women without OAB and with relatively high MENQOL scores, vasomotor symptoms and difficulty sleeping. Conclusions: The prevalence of OAB, particularly nocturia, increased with menopausal stage, and the association was obvious in women with other menopausal symptoms. This finding underscores the importance of addressing nocturia as a potential menopausal symptom in middle-aged women. Further studies are required to understand the mechanisms linking OAB with menopausal symptoms in middle-aged women.