Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study

Abstract

Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study.Andrada, Maria; Källén, Karin; Lidfeldt, Jonas; Samsioe, Göran; Teleman, Pia General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. To outline serum estradiol levels in perimenopausal women with stress, mixed or urge incontinence. We believe the majority of urgency symptoms in perimenopausal women to be caused by a pelvic floor dysfunction and a hypermobility of the bladder neck. If this is the case, there would be no difference in estradiol levels between the groups. Study design:Setting: university hospital. In the observational Women´s Health In the Lund Area study, a subset of 400/2221 women reporting urinary incontinence completed a detailed questionnaire regarding lower urinary tract symptoms and had their serum steroid hormone levels measured.Statistical analyses were made by Chi-square test, nonparametrical tests, ANOVA, multi-and univariate logistic regression analysis. Results:Stress incontinence was reported by 196, mixed incontinence by 153 and urge incontinence by 43 women. Serum estradiol did not differ significantly between stress incontinent (median 49.5 pmo/l, range 2.63-875.4), urge incontinent ( median 31.6 pmol/l, range 2.63-460.7) or mixed incontinent women ( median 35.5 pmol/l, range 2.63-787.9, p = 0.62). Logistic regression analysis correcting for age, parity, hormonal status, smoking, hysterectomy and BMI also failed to show any difference in estradiol levels between the groups (p=0.41-0.58). Conclusion:No significant differences in serum estradiol levels between stress, mixed or urge incontinent perimenopausal women could be demonstrated . 4Keywords:Female urinary incontinence; mixed urinary incontinence; serum estradiol; stress urinary incontinence; urge urinary incontinence.5

Role of serum steroid hormones in women with stress urinary incontinence: a case–control study

“…Contrary to our findings, some studies showed that higher circulating oestrogen levels were associated with UI of any type [13,22]. Nevertheless, it should be noted that these studies included a mixed cohort of patients with incontinence and not specifically women with SUI.…”

“…The median (range) BMI in the SUI group was 26 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) kg/m 2 and 9/47 women in this group (19%) were classified as obese, 20/47 (43%) were overweight and 18/47 (38%) had a normal BMI. The mean (AESD) score on the Oxford grading scale was 2.35 (AE0.706) and first desire to void occurred at 208 (AE47.07) mL.…”

Stress urinary incontinence and endogenous sex steroids in postmenopausal women

“…In the observational Women's Health in the Lund area study, 400 out of 2,221 postmenopausal women, aged 50–60 years old upon enrollment, reported incontinence symptoms. In 369 of these women in whom estradiol levels were available, no correlation between endogenous estradiol and incontinence in general or stress urinary incontinence in particular could be demonstrated …”

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

“…Aging and the menopause per se are associated with a progressive increase in the severity of UI and discomfort [28]. Despite this, serum estradiol has not been related to UI during the menopause transition [29,11], or with urodynamic parameters [30].…”

“…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].…”