Prevalence, Phenotypic Characteristics, and Quality of Life Impact of Genitourinary Syndrome of Menopause Among Nigerian Women

Genitourinary syndrome of menopause (GSM) encompasses a range of vulvovaginal, sexual, and urinary symptoms resulting from oestrogen deficiency, yet its prevalence and quality of life impact among Nigerian menopausal women remain empirically uncharacterised. This study determines the prevalence, phenotypic symptom profile, and quality of life impact of GSM among menopausal women in Lagos (South West), Enugu (South East), and Kano (North West). A cross-sectional multi-site study enrolled 300 postmenopausal women aged 45 to 65 years through gynaecology outpatient clinics. GSM was assessed using the Day-to-Day Impact of Vaginal Ageing (DIVA) questionnaire and clinical examination. Quality of life was measured using the Menopause Quality of Life (MENQOL) questionnaire. GSM prevalence was 53 percent. Vaginal dryness (78 percent), dyspareunia (62 percent), and urgency urinary incontinence (44 percent) were the most prevalent symptoms. DIVA scores were significantly higher in Kano than Lagos or Enugu, possibly reflecting lower health literacy and provider-patient communication quality. MENQOL sexual domain scores showed the greatest quality of life impairment. Only 14 percent of GSM-positive women had ever received treatment. The study fills a critical gap in Nigerian GSM epidemiology and recommends clinician-initiated GSM screening, vaginal oestrogen prescribing protocols, and GSM patient education resources in gynaecology outpatient settings across all three zones. Keywords: genitourinary syndrome of menopause, GSM, quality of life, postmenopausal women, Nigeria