Genitourinary syndrome of menopause: a multicenter study from the Indian Midlife Registry

This study aimed to investigate the prevalence and characteristics of genitourinary syndrome of menopause (GSM) in midlife women. The cross-sectional study from the Indian Midlife Registry included women aged >40 years attending outpatient clinics at multiple centers across India. Real-world data were collected on an Electronic Health Record platform. GSM was diagnosed in the presence of either two genitourinary or sexual symptoms or one symptom and a Vaginal Health Index (VHI) score of ≤15. A total of 1781 women, 826 perimenopausal and 955 postmenopausal, were included. The prevalence of GSM was 48.5%, and the most prevalent symptoms were lower urinary tract symptoms (LUTS) (38.2%) and vaginal dryness (26.4%). The VHI score was ≤15 in 42.1% of women. Based on logistic regression analysis, age ≥70 years, late postmenopause, low education, insomnia and other sleep problems were associated with higher odds of GSM. GSM is highly prevalent in Indian women. GSM remains under-recognized and undertreated. Sleep problems, advanced age, late postmenopause and low education significantly increase the odds. This study underscores the importance of routine screening for GSM, especially in those with sleep disturbances or LUTS in order to improve quality of life (QoL).