Sexual Activity and Urological Morbidities Among Nigerian Menopausal Women: Findings from a Community Based Survey

BACKGROUND: Menopause represents the end of women reproductive career and it is at this time they begin to manifest morbidities such as urinary incontinence. AIM: To document proximate determinants of sexual activity and urological morbidities of menopausal women. SUBJECTS AND METHODS: This was a community survey conducted among 254 menopausal women Mokola in Ibadan, Nigeria in 2008. Respondents were selected using cluster sampling technique. Interviewer administered questionnaires were used to obtain information on their characteristics, pattern of urological and sexual activities. Descriptive, bivariate and multivariable tests were performed with Statistical Package for the Social Sciences 15.0 (Chicago, IL USA) and statistical significance was set at P value less than 0.05. RESULTS: The mean age of subjects was 60.3 (standard deviation = 10.2 years). About 33.5% (85/254) was still sexually active. About 68% (173/254) reported a reduction in sexual frequency since menopause while 31.5% (80/254) reported no change. The mean self-rated sexual performance score was 4.3 based on a numerical scale where 10 is the maximum obtainable. Significant predictors of reduction in sexual activity were age at menopause and education. Those between 45 and 49 years were less likely than those at 55 years or more (odds ratio [OR] = 0.21; 95% confidence interval OR = 0.05-0.87) while women with at least secondary education were thrice less likely than those with none to report a reduction in sexual activity after menopause. Less than a tenth reported urinary incontinence as a complaint. Urge incontinence was the most commonly reported followed by dysuria and stress incontinence. Less than a quarter of them had requested for a form of treatment. CONCLUSION: Sexual performance of Nigerian menopausal women is associated with age at menopause and education. Non-fistulous urinary incontinence is now being mentioned as a complaint contrary to the widely held view that it is part of the aging process. Therefore, awareness creation on management opportunities should be shared with them.