Study design, materials and methods
A cross-sectional survey was conducted among women of reproductive age. An anonymous electronic survey was designed to assess storage voiding symptoms (2 questions), emptying voiding symptoms (4 questions), incontinence (2 questions), and vaginal pain (1 question) during and after menstruation, with each question scored on a scale from 0 to 5 ( 0 = Not at All, 1 = Less than 1 in 5 Times, 2 = Less than Half the Time, 3 = About Half the Time, 4 = More than Half the Time, 5 = Almost Always) and total score of 45. Pairwise t-tests were used to analyze changes in women's responses during and after their menstrual period.
Results
A total of 201 women responded to the survey, with a median age of 33 years (interquartile range, 28-37 years). Among them, 71% preferred menstrual pads or underwear (Group 1), while 29% used tampons, menstrual cups, or discs (Group 2). The prevalence of obstructive voiding symptoms was 20.2%. Group 1 exhibited a higher total score, indicating more severe symptoms during and after menstruation compared to Group 2 (Group 1: Group 2 = 5.00 ± 5.34: 3.73 ± 4.24).
In group 2, significant improvements were observed across most symptoms post-intervention, with notable changes in total scores (During the period: After the period = 3.73 ± 4.24: 1.23 ± 2.18, p < 0.0001), suggesting an improvement after the period. Specific symptoms like 'Difficulty in voiding' and 'Frequency' showed significant improvement (p = 0.0205 and p < 0.0001, respectively). However, 'Dysuria' and 'Urgency' did not show significant changes (p = 0.1328 and p = 0.1819, respectively).
The group 1 exhibited similar trends. Notable improvements were observed in total scores ((During the period: After the period = 5.00 ± 5.34: 3.02 ± 4.77, p < 0.0001)) and in symptoms such as 'Frequency' and 'Skin irritation' (p < 0.0001 for both). Some symptoms like 'SUI' showed no significant change (p = 0.6963), suggesting a heterogenous group.
Both groups showed significant improvements in total scores after menstruation and in obstructive voiding symptoms. However, the mean differences in all domains were less than 1, suggesting no clinically significant changes. Only one patient sought medical help due to the above symptoms.
Interpretation of results
Women of reproductive age exhibited statistically significant variations in domains associated with obstructive voiding symptoms. About 1/5 women had obstructive voiding symptoms during the period. however, differences were not clinically significant.