Moderate‐to‐high normal levels of thyrotropin is a risk factor for urinary incontinence and an unsuitable quality of life in women over 65 years

Abstract

SummaryThe present study aimed to investigate the relationship between normal serum concentrations of thyrotropin (TSH) and urinary incontinence (IU), urinary infections, and quality of life in old women. Euthyroid post-menopausal women without sarcopenia, estrogen replacement, emotional illness, and/or cancer were enrolled as participants. Anthropometric indicators, serum glucose and estradiol, and thyroid profile were measured. Sociodemographic, clinical, physical activity, and quality of life surveys were applied. One-hour pad test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were used to determine UI.Urinalysis was also done. In agreement with results from the pad test (cut-off point ≥1.4 g), the ICIQ-SF reveled approximately 50% of incontinent women. A high percentage of women had moderate-high bacteriuria and urinary infections. Logistic regression analysis showed that age is a risk factor for both UI and urinary infection.Diabetes, number of pregnancies or childbirths, urinary infections, and bacteriuria did not influence the presence of UI. To allocate women into four groups according to their age (<65 or ≥65 years old) and TSH concentrations (0.3-1.9 or 2-10 μUI/mL), we found that moderate-to-high normal levels of TSH is a risk factor for UI and a worse quality of life in the oldest women. Our results highlight the profit of measuring TSH concentrations in post-menopausal women. K E Y W O R D Sageing, ICIQ-SF, pad test, quality of life, thyroid hormones, thyrotropin | INTRODUCTIONPost-menopause is linked to an impaired function of the genitourinary tract. Thus, vulvovaginal atrophy, sexual dysfunctions, urine retention, urinary incontinence (UI), renal dysfunctions, and urinary infections are common among post-menopausal women.1-9 Moreover, genitourinary dysfunctions worsen the quality of life of women. 10,11Post-menopausal women also have a high prevalence of clinical and subclinical hypothyroidism.

Hypothyroidism impairs somatovisceral reflexes involved in micturition of female rabbits

“…Particularly, data from voiding efficiency and urethral resistance measurements are suggestive of urinary retention. Such results constitute one‐step forward in elucidating the mechanisms underlying the link between thyroid dysfunctions and urinary problems . Interestingly, the increased urethral resistance may lead to overflow urinary incontinence that could partially explain the link between thyroid problems and stress urinary incontinence .…”

“…Clinical findings support that thyroid dysfunctions are linked to pelvic floor disorders including urinary incontinence and urinary retention . Moreover, epidemiological findings clearly indicate that thyroid problems are a risk factor to develop SUI in women .…”

“…Scant studies have reported that urinary dysfunctions are related to thyroid problems and, particularly, to hypothyroidism in women . However, the mechanisms involved remain to be addressed.…”

Aging mechanisms and intervention targets

“…Post‐menopause is associated with vulvovaginal atrophy, sexual dysfunction, urine retention, urinary incontinence (UI), renal dysfunction and urinary infections in women with high prevalence of hypothyroidism . In the study to investigate the relationship between normal serum concentrations of thyrotropin (TSH) and urinary incontinence (IU), it has been found that moderate‐to‐high normal levels of TSH is a risk factor for urinary incontinence in women over 65 years, so managing thyrotropin levels in the aging may warrant further investigation …”

“…Interestingly, recent studies show that epicutaneous exposure to ovalbumin (OVA) followed by an inhaled OVA challenge results in reduced immune responses to the OVA‐induced sensitization in elderly animals, with low systemic levels of OVA‐IgE and BALF levels of leukocytes, eosinophils and T helper cell type 2 cytokines but increased suppressive interleukin‐10 (for details, see Cuevas‐Romero). Thus, immune responses of senescent tissue stem and differentiated cells in lungs may differ in inflammasome sensing and signalling during aging.…”