Genitourinary symptoms and sexual dysfunction in women with premature ovarian insufficiency: a cross-sectional study...

This study aimed to characterize genitourinary symptoms and sexual function in women with premature ovarian insufficiency (POI) and to compare these findings with those in age-comparable women with regular menstruation.

This questionnaire-based cross-sectional study identified women with POI who attended the First Hospital of Hebei Medical University between April 2022 and October 2025. Eligible women were invited to complete questionnaires between October and December 2025 through telephone interviews or outpatient follow-up visits. General genitourinary symptoms were assessed using a structured questionnaire. Female sexual function was evaluated using the Female Sexual Function Index (FSFI), and urinary incontinence-related outcomes were assessed using the International Consultation on Incontinence Questionnaire (ICIQ). Multivariable linear regression analysis was performed to identify factors associated with FSFI total score, with sensitivity analysis excluding the FSFI lubrication domain.

Among 207 invited women with POI, 149 returned valid questionnaires, yielding a valid response rate of 72.0%. In addition, 51 age-comparable women with regular menstruation completed questionnaires as controls. Compared with controls, women with POI had more frequent vulvovaginal dryness, whereas vulvovaginal itching, vulvovaginal burning, and individual lower urinary tract symptoms did not differ significantly. Neither the ICIQ total score nor the proportion of moderate-to-severe urinary incontinence differed significantly between groups. Among women with a history of sexual activity, those with POI had lower FSFI total scores and a higher prevalence of female sexual dysfunction, with impairment in arousal, lubrication, orgasm, satisfaction, and pain. In multivariable linear regression analysis, vulvovaginal dryness was independently associated with lower FSFI total score (B = -0.804, 95% CI: -1.152 to -0.457, P < 0.001). This association remained significant after excluding the lubrication domain in sensitivity analysis (B = -0.624, 95% CI: -0.910 to -0.338, P < 0.001).

Women with POI showed a clinically meaningful early genitourinary symptom burden characterized predominantly by vulvovaginal dryness and multidimensional sexual dysfunction, whereas overt urinary incontinence severity was not significantly increased. Vulvovaginal dryness showed the most consistent association with impaired sexual function and may serve as a clinical clue to sexual dysfunction in women with POI.