Lower urinary tract symptoms (LUTS)

Content written by Rachel N. Pauls MD

Lower urinary tract symptoms including urgency, frequency, nocturia and difficulty emptying may be associated with sexual problems. Although the precise mechanism is not known, several authors have documented these symptoms as risk factors for sexual function problems in women and men. Hypothetical reasons include interference or discomfort with sexual activity, impact on overall sense of well-being, and concurrent depression. Sexual problems noted include impaired or low desire, changes in arousal and orgasm and pain with intercourse.

Treatments for LUTS may improve sexual dysfunction at the same time. Vaginal estrogen preparations reduce irritative voiding symptoms as well as address arousal and lubrication disorders. Controlling overactive bladder symptoms with anticholinergic medications may alleviate sexual function problems. In extreme cases, sacral neuromodulation may be suggested; small studies of this therapy documented concomitant improvements in all parameters of sexual health. Finally, pelvic floor physical therapy has enhanced sexual function in women with urinary symptoms.

While many of these symptoms are common, they can have a negative impact on various parameters of quality of life. Discussions with your health care provider are the first step in addressing and improving these significant problems.