Oral Contraceptive Use and Incident Urinary Incontinence in Premenopausal Women

Abstract

Purpose Recent data in postmenopausal women indicate that current and past use of exogenous hormones is related to urinary incontinence (UI) risk. Little is known about exogenous hormones and UI risk in younger women. We investigated the association between oral contraceptive pills (OCPs) and incident UI in premenopausal women enrolled in the Nurses' Health Study II. Materials and Methods Participants reported use of OCPs from 1989 to 2001. Among 21,864 premenopausal women, aged 37-54 years, reporting no UI in 2001, we identified 749 cases with incident UI at least weekly between 2001 and 2003. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression. Results Women who had ever used OCPs had statistically significant 27% (95% CI 1-59%) increased odds of developing UI at least weekly compared with women who never used OCPs. Among women with 10 or more years of use, the odds ratio increased to 1.48 (95% CI 1.13-1.95). Ever use of OCPs was specifically associated with urgency UI (OR 2.48, 95% CI 1.07-5.76) and not stress UI (OR 1.04, 95% CI 0.78-1.40). Although we had limited information on urinary tract infection, control for urinary tract infection did not alter these findings. Conclusions Use of OCPs may be associated with a modest increase in odds of UI among premenopausal women. However, this is one of the first reports of such an association and thus, further research is needed to confirm our findings and investigate possible mechanisms.

Frequency and Determinants of Urinary Incontinence in Adolescent and Young Nulliparous Women

“…A large cohort study found a significantly reduced risk for UI in COC users 22 , but, according to others 23 , women between 25 and 42 years old who had ever used COC have an increased risk for the incidence of UI, especially for urgency UI.…”

Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT)

“…Other studies have identified age [32], BMI [25,33], weight gain [25,33], oral contraceptive use [34] and physical function and psychiatric illness [28,35] among risk factors associated with incident UI. In the current study we identified BMI as a risk factor for incident UI, whilst weight change and parity were found to be associated with incident UI.…”

Associations of Commonly Used Medications with Urinary Incontinence in a Community Based Sample

“…In the Nurses’ Health Study, oral contraceptives increased risk of incident UI among younger women, 21 while postmenopausal hormone therapy increased risk among older women, with diminishing risk upon cessation of use. 22 Similarly, in the Women’s Health Initiative, conjugated estrogen preparations increased risk of UI among continent women, and worsened prevalent incontinence. 23 Ruby et al .…”