Vaginal Hormone Therapy for Conditions of the Lower Urinary Tract

Nemirovsky, Amy; Villela, Natalia Arias; Yuan, J. Christine; Patil, Rajendra D.; Malik, Rena D.

doi:10.1007/s11934-022-01132-7

Cited by 4 publications

(4 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is possible that combination with other therapies such as chondroitin sulfate, targeting the glycosaminoglycan layer, might improve efficacy. 32 Which women and what ancillary therapy remains uncertain. Also unclear is the optimum usage of all the options for prevention of rUTI or their sequence in clinical practice.…”

Section: Uncertainties Regarding the Evidencementioning

confidence: 99%

See 1 more Smart Citation

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI‐RS 2023

Taithongchai,

Mohamed‐Ahmed,

Sinha

et al. 2024

Neurourology and Urodynamics

View full text Add to dashboard Cite

AimsThis International Consultation on Incontinence‐Research Society report aims to summarize the evidence and uncertainties regarding the use of hormone replacement therapy by any route in the management of lower urinary tract symptoms (LUTS) including recurrent urinary tract infections (rUTI), with a review of special considerations for the elderly. Research question proposals to further this field have been highlighted.MethodsAn overview of the existing evidence, guidelines, and consensus regarding the use of topical or systemic estrogens in the management of LUTS.ResultsThere are currently evidence and recommendations to offer topical estrogens to postmenopausal women with overactive bladder symptoms as well as postmenopausal women with rUTIs. Systemic estrogens however have been shown in a meta‐analysis to have a negative effect on LUTS and, therefore are not currently recommended.ConclusionsAlthough available evidence and recommendations exist for the use of topical estrogens, few women are commenced on these in primary care. There remain large gaps still within our knowledge of the use of estrogens within the management of LUTS, particularly on when it should be commenced, the length of time treatment should be continued for, and barriers to prescribing.

show abstract

Section: Uncertainties Regarding the Evidencementioning

confidence: 99%

“…Evidence on duration of therapy, optimum formulation, dose, and mode of delivery are lacking. It is possible that combination with other therapies such as chondroitin sulfate, targeting the glycosaminoglycan layer, might improve efficacy 32 . Which women and what ancillary therapy remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI‐RS 2023

Taithongchai,

Mohamed‐Ahmed,

Sinha

et al. 2024

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…These are useful solutions for solving genitourinary problems [126,127]. Topical (topically applied) HRT does not resolve hot flushes, but it can act on vaginal dryness; these therapies usually consist of creams with estrogen in small quantities to be applied directly into the vagina [128,129].…”

Section: Managementmentioning

confidence: 99%

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

Comparetto,

Borruto

2023

OBM Geriatr

View full text Add to dashboard Cite

In the United States (US), menopause occurs at an average age of 52. Menopausal symptoms tend to be maximal during the few years before and the year after menopause (during perimenopause), except for symptomatic vulvovaginal atrophy, which may worsen over time. Up to 20% of bone density loss occurs during the first 5 years after menopause, followed by an age-related bone loss rate similar to that in men. Menopause should be considered confirmed if an age-appropriate woman who is not pregnant has not had a menstrual period for 12 months. Regarding treatment, for vaginal dryness or dyspareunia due to menopause, vaginal stimulation and vaginal lubricants and moisturizers are recommended, and if these are ineffective, low-dose vaginal estrogen, in the form of creams, tablets, suppositories, or rings should be considered; other options include oral ospemifene or intravaginal dehydroepiandrosterone (DEHA) suppositories. Before prescribing hormone replacement therapy (HRT) and periodically while therapy continues, women should be informed of risks (e.g., deep vein thrombosis [DVT], pulmonary embolism [PE], stroke, breast cancer, gallbladder disease, and urinary incontinence); potential harms are greatest for women who start HRT after 60 years of age or who are 10-20 years past menopause onset. If women choose HRT to relieve hot flushes, estrogen plus, a progestin or conjugated estrogen/bazedoxifene could be prescribed for women who still have the uterus. Treatment with HRT should be tailored to maximize benefits and minimize harms, and periodically benefits and harms should be reassessed; low-dose transdermal HRT may lead to a lower risk of DVT and stroke. Selective serotonin reuptakereuptake inhibitors (SSRIs), selective serotonin-nor-epinephrine reuptake inhibitors (SNRIs), and gabapentin could be considered as less effective alternatives to HRT for relieving hot flushes; paroxetine 7.5 milligrams (mg) is the only non-hormonal drug approved in the US for the relief of hot flushes. Effective non-drug options include cognitive behavioral therapy and hypnosis.

show abstract

“…Vaginal estrogen and DHEA are also shown to protect against recurrent urinary tract infections. 11 Similarly, hypogonadal men who present with LUTs improve with testosterone supplementation. Testosterone increases bladder capacity and compliance and decreases detrusor pressure at maximal flow in men with late-onset hypogonadism.…”

Section: Sex Hormones and Bladder Functionmentioning

confidence: 99%

The endocrinology of the urinary bladder

Saptarshi Bhattacharya,

Arbinder Kumar Singal,

Sanjay Kalra

2023

J Pak Med Assoc

View full text Add to dashboard Cite

The urinary bladder primarily functions as a reservoir for urine. Apparently, it serves only a mechanical and passive role in the urinary tract, but closer scrutiny reveals that it has several meaningful endocrine interactions. This vital organ has an intricate plexus of neurons that release neurohormones concerned with the functioning of the bladder. Endocrine disorders, most notably diabetes, can cause a broad spectrum of bladder dysfunction. The current review explores the bladder as a source of neurotransmitters, a target for organ damage due to uncontrolled endocrinopathy, a beneficiary of hormonal therapy, and a tool to improve endocrine health. Keywords: Urinary bladder, diabetes, lower urinary tract symptoms, overactive bladder, urinary obstruction

show abstract

Vaginal Hormone Therapy for Conditions of the Lower Urinary Tract

Cited by 4 publications

References 39 publications

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI‐RS 2023

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI‐RS 2023

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

The endocrinology of the urinary bladder

Contact Info

Product

Resources

About