The impact of perceived vaginal and urinary symptoms and treatment burden in predicting sexual functioning among perimenopausal and postmenopausal women.

Abstract

This study aimed to explore the relationship between urogenital symptom frequency and severity, perception of vaginal treatment burden, and female sexual desire, arousal, and satisfaction. A cross-sectional study was conducted with a sample of 326 patients from three tertiary care hospitals in the United Arab Emirates. The frequency and severity of urogenital symptoms, emotional and physical functioning, and treatment burden were assessed using the validated genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVATQ). To examine the mediating roles of emotional and physical functioning, as well as the perceived treatment burden on sexual functioning, a partial least squares-structural equation model was developed using the SmartPLS 4 Software. The measurement model was successfully established. All constructs had a reliability of > 0.70 and discriminant validity of < 0.90. Emotional, physical and sexual functioning showed an adjusted R2 values of 0.377, 0.282 and 0.169, respectively.The multistep multiple mediator model revealed a full mediation effect of both emotional and physical functioning between symptom, treatment burden and sexual functioning. The model showed high predictive performance with all manifest variables showing lower mean absolute errors compared to the naiive benchmark model. This study enhances our understanding of the relationships between urogenital symptoms, perceived treatment burden, emotional functioning, and sexual well-being. The findings emphasize the importance of addressing emotional well-being in managing urogenital symptoms and in addressing emotional factors associated with the use of vaginal treatments.