The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation

Four hundred and eighty-three consecutive women referred for videocystouret hrography completed a structured questionnaire about their menstrual status and urinary symptoms. Women were included in the study if they were premen opausal, had a regular menstrual cycle and were not taking hormonal therapy . One hundred and thirty-three women satisfied the inclusion criteria of wh om 55 (41%) complained that their urinary symptoms were cyclical. The times at which symptoms were said to be at their worst were reported by the wome n as follows: during a period (n = 20; 36%); just after a period (n = 4; 7% ); middle of the month (n = 8; 15%) just before a period (n = 23; 42%). The prevalence of abnormal detrusor activity on videocystourethrography increa sed significantly with time from the last menstrual period (chi (2) for tre nd = 6.56, P = 0.01) and might reflect increases in the circulating level o f progesterone following ovulation. This study provides further indirect ev idence that progesterone could have an adverse effect on female lower urina ry tract function. In addition, it might be necessary to consider the stage within the menstrual cycle when interpreting the results of urodynamic inv estigation.