Management of urinary incontinence in postmenopausal women: An EMAS clinical guide

Russo, Eleonora; Caretto, Marta; Giannini, Andrea; Bitzer, Johannes; Cano, Antonio; Ceaușu, Iuliana; Chedraui, Peter; Durmuşoğlu, Fatih; Erkkola, Risto; Goulis, Dimitrios G.; Kiesel, L.; Lambrinoudaki, Ιrene; Hirschberg, Angelica Lindén; Lopès, P.; Pines, Amos; Rees, Margaret; Trotsenburg, Mick van; Simoncini, Tommaso

doi:10.1016/j.maturitas.2020.09.005

Cited by 40 publications

(37 citation statements)

References 94 publications

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“…Reductions in UTIs with improvements in urinary continence and overactive bladder symptoms all usually occur with transvaginal estrogen use. [7][8][9][10][11][12] One study demonstrated the estradiol ring releasing 7.5 μg per 24 hours and oral oxybutynin to have comparable efficacy for the treatment of overactive bladder. 13…”

Section: Alleviation Of Gsm Symptomsmentioning

confidence: 99%

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development

Laing¹,

Newson²,

Simon

2022

Cancer J

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Several formulations of intravaginal oestrogen are available for the treatment of genitourinary syndrome of menopause (GSM). These are safe and effective treatments for the symptoms of GSM. Licensed doses of intravaginal oestrogen do not elevate systemic estradiol levels above the normal postmenopausal range with long term use and there is no evidence of an increased risk of coronary heart disease, stroke, thromboembolism, colorectal cancer, endometrial cancer, breast cancer or breast cancer recurrence with their use. This should reassure both women and their healthcare professionals and should lead to more women receiving these localised, vaginally administered hormonal treatments. Available evidence also suggests a positive safety profile for transdermal testosterone treatment when delivered at physiological concentrations.

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Section: Alleviation Of Gsm Symptomsmentioning

confidence: 99%

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development

Laing¹,

Newson²,

Simon

2022

Cancer J

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“…There is also evidence that topical estrogens may improve urinary incontinence and prevent recurrent urinary tract infections [25,26,27,28]. There are insufficient high-quality data to support the use of vaginal estrogens for stress urinary incontinence after the menopause.…”

Section: Efficacymentioning

confidence: 99%

“…In contrast, systemic MHT seems to worsen urinary incontinence. However, the evidence base consists mainly of large epidemiological studies primarily investigating the use of systemic MHT for the prevention of cardiovascular disease and osteoporosis, with urinary incontinence being investigated as a secondary outcome [25].…”

Section: Efficacymentioning

confidence: 99%

Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide

et al. 2021

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Introduction: Vulvovaginal atrophy (VVA) is a chronic condition caused by estrogen deficiency. It affects around 50% of postmenopausal women, reducing their general and sexual quality of life as well as the quality of their personal relationships. Aim: The aim of this clinical guide is to set out an individualized approach to the management of VVA with topical estrogens and non-hormonal preparations. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: An individualized approach is required for the management of VVA. Topical low-dose estrogens are effective and also alleviate urinary incontinence and prevent recurrent urinary tract infections. Women should not be denied long-term use of topical estrogens as long as they feel that this treatment is of benefit to them, because the safety data are reassuring. Non-hormonal preparations (lubricants and moisturizers) should be the first-line treatment for VVA in women taking adjuvant endocrine therapies for cancers considered to be hormone-dependent. They can be used over the long term.

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“…In recent years, in parallel with the development of the social economy, the diagnosis and treatment of SUI have attracted more and more attention from the medical profession, with the development of newer diagnoses and treatment methods. Presently, the treatment of mild to moderate SUI often uses conservative therapies, such as biofeedback therapy 11 , pelvic oor muscle training 12 , and drug therapy such as topical estrogen therapy 13 . Severe SUI treatment is usually based on surgical methods, including mesh vaginal surgery 14 , placement of synthetic slings 15 , local injection of bulking agents, and implantation of arti cial urinary sphincters 16,17 .…”

Section: Introductionmentioning

confidence: 99%

Application of estrogen for the treatment of stress urinary incontinence in mice

Hong

et al. 2022

Arch Gynecol Obstet

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Background The etiology of stress urinary incontinence (SUI) is complex and diverse among women, with past studies having demonstrated that estrogen de ciency is an important cause of pelvic oor muscle atrophy and urethral degeneration. We comprehensively investigated the effects of estrogen in the treatment of SUI in female mice at cellular and animal levels.Methods L929 cell mechanical injury model was established by four point bending device, and SUI mouse model was established by vaginal dilation method commonly used to simulate labor injury. After treatment, the expressions of collagen I, collagen III, elastin, TIMP-1, TIMP-2, MMP-2 and MMP-9 were detected, the leak point pressure (LPP) and abdominal leak point pressure (ALPP) of mice in each group were detected, and the effect of estrogen on extracellular matrix remodeling of mouse urethra and anterior vaginal wall was observed from the histological level.Results These results revealed that an appropriate amount of estrogen can promote the expression of collagen I, collagen III, elastin, TIMP-1, and TIMP-2, decrease the expression of MMP-2 and MMP-9, and maintain the dynamic balance of MMPs/TIMPs at both cellular and animal levels. Meanwhile, we determined that estrogen can increase the LPP and ALPP values of SUI mice. The collagen bers' content in the mice treated with estrogen was signi cantly greater than in the control group mice.Conclusions The estrogen may alleviate the symptoms of SUI by reconstituting ECM, toward laying a solid foundation for the further exploration of estrogen therapy.

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Management of urinary incontinence in postmenopausal women: An EMAS clinical guide

Cited by 40 publications

References 94 publications

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development

Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide

Application of estrogen for the treatment of stress urinary incontinence in mice

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