Urogenital Symptoms are Associated With Bone Mineral Density but not With Metabolic Syndrome in Postmenopausal Women: A Prospective Cross-Sectional Study

Background: Menopause imposes a significant physical and emotional burden on women, affecting their quality of life and overall health. Beyond these challenges, the decline in estrogen levels during menopause is closely associated with adverse changes in bone health and an increased risk of developing metabolic syndrome (MetS), both of which contribute to long-term morbidity. The primary hypothesis of the current study was that the co-existence of low bone mineral density (BMD) and MetS would exacerbate the severity of menopausal symptoms. As the most bothersome menopausal symptoms typically emerge one year before the final menstrual period and gradually subside thereafter, we investigated BMD, MetS, and menopause-related symptoms in postmenopausal women within 10 years of menopause onset. Methods: A total of 193 postmenopausal women were included in this cross-sectional study, which was conducted at a university hospital in Istanbul. At baseline, participants were categorized into MetS and non-MetS groups based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. For comparative analyses, participants were stratified according to MetS status and BMD. Women with osteopenia or osteoporosis based on BMD measurements were combined into the low BMD group. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Results: Women with MetS were significantly older and had a longer duration of menopause than those without MetS. All MRS scores were comparable between the MetS and non-MetS groups. Women with low BMD were older, had a longer duration of menopause, and a lower body mass index (BMI) compared to those with normal BMD. The MRS urogenital symptom subscale score was significantly higher among women with low BMD (p = 0.019). Severe urogenital symptoms were observed among women with co-existence of MetS and low BMD. Correlation analyses between MRS scores and other variables yielded negligible negative correlations with age. Conclusions: Low BMD was associated with higher scores on the urogenital subscale of the MRS, whereas MetS showed no significant relationship with menopausal symptoms. Women with both low BMD and MetS experienced more severe urogenital symptoms.