Overactive bladder in the female patient: The role of estrogens

Abstract

The prevalence of urinary incontinence is known to increase with age, affecting 15% to 35% of communitydwelling women older than 60 years of age, and other studies report a prevalence of 49% in women older than 65 years. Epidemiologic studies have implicated estrogen deficiency in the etiology of lower urinary tract symptoms, although to date the role of estrogen replacement therapy is controversial. The aim of this paper is to review the recent evidence regarding the effect of estrogen in lower urinary tract dysfunction, with a particular emphasis on the management of symptoms suggestive of overactive bladder in postmenopausal women.

The Association of Adiposity and Overactive Bladder Appears to Differ by Gender: Results From the Boston Area Community Health Survey

“…It is possible that other factors produced by adipose tissue could exert inhibitory effects on bladder function in men, while pelvic floor laxity in women overcome this effect and mechanical factors differentially lead to OAB. With obesity in men, not only could vascular factors or leptins play a role, but conversion of androgens to estrogens by adipose tissue could lead to OAB28. Thus the mechanisms underlying our findings although speculative are quite diverse.…”