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Male hormones play role in incontinence in women

24 Sep 2017

Women with very low levels of serum testosterone may have an increased likelihood of stress and mixed incontinence, a recent study suggests.

Researchers looked at 2,321 women aged >20 years from the 2012 cycle of National Health and Nutrition Examination Survey (NHANES). All women underwent serum total testosterone measurement and completed urinary incontinence questions.

The association between serum testosterone levels and incontinence was tested using a weighted, multivariate logistic regression model. Age, body mass index, diabetes, race, parity, menopause and time of venepuncture were included in the analysis as potential confounders.

In the cohort, the prevalence of stress urinary incontinence was 37.5 percent, urge urinary incontinence was 29.8 percent and mixed urinary incontinence was 16.4 percent.

Women having serum testosterone concentrations in the lowest quartile were highly likely to complain of stress incontinence (odds ratio [OR], 1.45; 95 percent CI, 1.03 to 2.12) and mixed incontinence (OR, 1.68; 1.23 to 2.22).

Urge incontinence was not associated with serum testosterone levels.

In light of the role of pelvic musculature in preserving urethral support and the anabolic effect of androgens on skeletal muscle, researchers suggested that the association between serum testosterone levels and urinary incontinence among women may involve a physiologic mechanism.

The said mechanism should be further evaluated in prospective and translational studies, researchers added.

Urinary incontinence is a common health problem among women, highly prevalent in older women. One of the risk factors for incontinence is obesity, as pelvic floor integrity is essential in the maintenance of urinary continence. Excess adiposity has been shown to increase intra-abdominal pressure, therefore exposing the pelvic support structures and organs to a chronic state or stress. [Clinics (Sao Paulo) 2011;66:1911–1915]

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