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Erschienen in: International Urogynecology Journal 2/2019

01.02.2019 | Original Article

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

verfasst von: Päivi Rahkola-Soisalo, Hanna Savolainen-Peltonen, Mika Gissler, Fabian Hoti, Pia Vattulainen, Olavi Ylikorkala, Tomi S. Mikkola

Erschienen in: International Urogynecology Journal | Ausgabe 2/2019

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Abstract

Introduction and hypothesis

The impact of estradiol-based hormone therapy (HT) on the incidence of stress urinary incontinence (SUI) is unknown. Therefore, we compared the use of such HT regimens and tibolone in women with and without SUI.

Methods

The women with a history of SUI operation (N = 15,002) were identified from the Finnish National Hospital Discharge Register, and the control women without such an operation (N = 44,389) from the Finnish Central Population Register. The use of HT was traced from the National Drug Reimbursement Register, and the odd ratios (ORs) with 95% confidence intervals (95% CIs) for SUI were calculated by using the conditional logistic regression analysis.

Results

The cases had used any HT more often than the controls. The use of systemic estradiol-only or estradiol–progestin therapy was accompanied by an increased SUI risk (OR 3.8, 95% CI: 3.6–4.0 and OR 2.7, 95% CI: 2.6–2.9 respectively). The use of estradiol with noretisterone acetate showed a higher risk of increase than that with medroxyprogesterone acetate. Age over 55 years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55 years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.

Conclusions

The use of HT regimens may predispose to the de novo development or worsening of pre-existing SUI. Thus, caution is needed when these regimens are prescribed to women with mild stress-related urine leakage or with established SUI risk factors.
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Metadaten
Titel
Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy
verfasst von
Päivi Rahkola-Soisalo
Hanna Savolainen-Peltonen
Mika Gissler
Fabian Hoti
Pia Vattulainen
Olavi Ylikorkala
Tomi S. Mikkola
Publikationsdatum
01.02.2019
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 2/2019
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3682-7

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