Low serum testosterone tied to stress, mixed incontinence in women

05 Feb 2018
Low serum testosterone tied to stress, mixed incontinence in women

Women with low serum testosterone are likely to develop stress and mixed incontinence, a recent study has found.

Of the 2,321 women included in the analysis, 37.5 percent had stress incontinence, 29.8 percent had urge incontinence and 16.4 percent had mixed incontinence. Those in the lowest quartile of serum testosterone had an increased likelihood of complaining of stress (odds ratio [OR], 1.45; 95 percent CI, 1.03‒2.12) and mixed incontinence (OR, 1.68; 1.23‒2.22).

There was no association observed between serum testosterone levels and urge incontinence.

“Given the role of pelvic musculature in maintaining urethral support and the anabolic effect of androgens on skeletal muscle, a physiological mechanism for this relationship can be proposed and further evaluated in prospective and translational studies,” the investigators said.

The study included women (>20 years) in the 2012 National Health and Nutrition Examination Survey cycle who had undergone serum total testosterone measurement and completed self-reported urinary incontinence questions.

The investigators used a weighted, multivariate logistic regression model to determine the relationship between incontinence and serum testosterone levels after adjusting for age, race, parity, menopause, diabetes, body mass index and time of venipuncture.

“Pelvic floor integrity is an important predictor of stress urinary incontinence. Androgen receptors have been found in the pelvic floor musculature and fascia, and testosterone administration has been shown to increase levator ani hypertrophy and improve stress incontinence in a rodent model,” the investigators said.

In one study, researchers found some differences involving measurement of the thickness and the area of the limbs of the levator ani muscle in women with and without stress urinary incontinence and without the genital tract prolapse in both groups. Such differences could have implications in physiotherapy of the pelvic floor muscles in women without statics abnormalities. [Ginekol Pol 2012;83:669-673]

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