Introduction: Hormonally mediated vestibulodynia (HMV) is a very common condition affecting up to 30% of women yet is poorly diagnosed and treated. The cause of HMV is secondary to testosterone deficiency which can be caused by various things (i.e medications, menopause, breast feeding, etc) Although the primary symptoms of HMV are associated with dyspareunia, patients with HMV often have bothersome lower urinary symptoms that are often misdiagnosed as recurrent urinary tract infections (rUTI). Both conditions have profound impact on the psychological and social well-being of patients. We hypothesize that there is a correlation between patients with self-reported rUTI and HMV
Objective: The purpose of this study is to assess the correlation of self-reported rUTI and HMV Methods: We performed a retrospective chart review of patients over a 12-month period presenting to our vulvar sexual health clinic with a primary complaint of self-reported rUTIs We defined self-reported as a history of negative urine cultures despite positive symptoms. All patients underwent a comprehensive evaluation including a detailed history, comprehensive vulvar exam including assessment of the vestibule with a Q-tip, pelvic floor assessment, comprehensive hormone labs in premenopausal women including estrogen, testosterone, SHBG, free testosterone, FSH, LH, prolactin, TSH, urine culture, and cystoscopy /renal US if indicated by the guidelines. Patients that demonstrated vestibular tenderness on exam with correlated low free testosterone or post-menopausal status were diagnosed with HMV. Results: There was a total of 107 patients seen for evaluation of self-reported rUTIs. The median age was 57. 55.1% (59/107) of patients were post-menopausal and 44.9% (48/107) pre-menopausal. Of the 107 patient, 64 (60%) were diagnosed with HMV. When stratifying for menopause status, 50% of the menopausal cohort were diagnosed with HMV and 73% of the premenopausal cohort were diagnosed with HMV. The average free testosterone of the premenopausal women was 0.23 ng/dl (goal = 0.8ng/dl) Conclusions: There is a high correlation between HMV and lower urinary tract symptoms. Further studies are needed to elicit if treatment of HMV can eradicate symptoms of lower urinary tract symptoms in certain demographics. SOURCE OF Funding: N/a
