Self-reported estrogen use and newly incident urinary incontinence among postmenopausal community-dwelling women

Abstract

OBJECTIVE To examine the relationship between self-reported estrogen use and newly-incident urinary incontinence (UI) among community-dwelling postmenopausal women. METHOD A population based longitudinal survey of postmenopausal women who did not report UI in 1993 and for whom complete data were available. Women were classified as having newly-incident UI if they reported uncontrolled urine loss within 12 months of the 2004 interview. Condition-specific functional loss secondary to UI was assessed by questions on participants’ inability to engage in certain activities due to UI. Duration of hormone therapy containing estrogen was obtained in 1993 using a structured questionnaire. RESULTS Among 167 postmenopausal women who did not report UI in 1993, 47 (28.1%) reported newly-incident UI and 31 (18.6%) reported newly-incident UI with condition-specific functional loss in 2004. Of the 167 postmenopausal women, 46 (27.5%) reported ever using hormone therapy containing estrogen and 14 (8.3%) women reported using hormone therapy containing estrogen for 5 years or more in 1993. Estrogen use for 5 years or more was significantly associated with newly-incident UI with condition-specific functional loss compared to estrogen use for less than 5 years or no reported history of estrogen (adjusted relative odds (RO) = 3.97, 95% confidence interval (CI) [1.02, 15.43]) in multivariate models controlling for potentially influential characteristics. CONCLUSIONS Postmenopausal community-dwelling women with a history of estrogen use for 5 years or more were more likely to report newly-incident UI with condition-specific functional loss after 10 years of follow-up.

Urinary incontinence, related factors and menopause-related quality of life in mid-aged women assessed with the Cervantes Scale

“…Urogenital tissue may display sensitivity responses varying in accordance to different estrogen levels [5]. Decreased estradiol levels may cause bladder dysfunction and reduce uretral closure which may contribute or exacerbate an existing UI [3,4,6,7]. Despite this, several reports have failed to demonstrate that hormone therapy (HT) improves urinary symptoms (i.e.…”

“…Despite this, several reports have failed to demonstrate that hormone therapy (HT) improves urinary symptoms (i.e. incontinence, urge syndrome) in postmenopausal women [7][8][9][10][11]. Important to state is that subjective sensation related to UI does not always correlate with urodynamic findings [12].…”

Menopause, hormone treatment and urinary incontinence at midlife

“…The overall risk of UI remained low however, with an annual incidence of 1.6%, and the effects of HRT disappeared when treatment ceased.A recent cohort study of post-menopausal women found an association between UI symptoms and duration of oestrogen treatment. Prolonged oral oestrogen therapy (5 years or more) is associated with a worsening of leakage symptoms (OR = 3.99[1.21-13.1]) and also an increase in the frequency of handicapping UI (3.97 [1.02-15.4])[37] (LE3).…”

Specific features of therapy for disordered urination in menopausal women

“…Корреляция между симптомами недержания мочи и продолжительностью приема эстрогенов выявлена в ко-гортном исследовании женщин в постменопаузе [36]. Пролонгированный прием эстрогенов (более 5 лет) ассо-циировался с повышением риска развития недержания мочи (ОР=3,97 при 95% ДИ 1,02-15,4) и ухудшением те-чения симптомов заболевания (ОР=3,99 при 95% ДИ 1,21-13,1).…”