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

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Introduction and hypothesisThe 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.MethodsThe 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.ResultsThe 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 55years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.ConclusionsThe 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.

Original languageEnglish
JournalInternational Urogynecology Journal
Volume30
Issue number2
Pages (from-to)251-256
Number of pages6
ISSN0937-3462
DOIs
Publication statusPublished - Feb 2019
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3123 Gynaecology and paediatrics
  • Estradiol
  • Hormone therapy
  • Menopause
  • Stress urinary incontinence
  • FREE VAGINAL TAPE
  • ESTROGEN
  • MENOPAUSE
  • ESTRADIOL

Cite this

@article{4f3ff81ab4874fb8b55850852b4dd7f8,
title = "Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy",
abstract = "Introduction and hypothesisThe 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.MethodsThe 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.ResultsThe 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 55years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.ConclusionsThe 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.",
keywords = "3123 Gynaecology and paediatrics, Estradiol, Hormone therapy, Menopause, Stress urinary incontinence, FREE VAGINAL TAPE, ESTROGEN, MENOPAUSE, ESTRADIOL",
author = "P{\"a}ivi Rahkola-Soisalo and Hanna Savolainen-Peltonen and Gissler Mika and Fabian Hoti and Pia Vattulainen and Olavi Ylikorkala and Mikkola, {Tomi S.}",
year = "2019",
month = "2",
doi = "10.1007/s00192-018-3682-7",
language = "English",
volume = "30",
pages = "251--256",
journal = "International Urogynecology Journal",
issn = "0937-3462",
publisher = "Springer",
number = "2",

}

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy. / Rahkola-Soisalo, Päivi; Savolainen-Peltonen, Hanna; Mika, Gissler; Hoti, Fabian; Vattulainen, Pia; Ylikorkala, Olavi; Mikkola, Tomi S.

In: International Urogynecology Journal, Vol. 30, No. 2, 02.2019, p. 251-256.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

AU - Rahkola-Soisalo, Päivi

AU - Savolainen-Peltonen, Hanna

AU - Mika, Gissler

AU - Hoti, Fabian

AU - Vattulainen, Pia

AU - Ylikorkala, Olavi

AU - Mikkola, Tomi S.

PY - 2019/2

Y1 - 2019/2

N2 - Introduction and hypothesisThe 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.MethodsThe 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.ResultsThe 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 55years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.ConclusionsThe 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.

AB - Introduction and hypothesisThe 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.MethodsThe 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.ResultsThe 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 55years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.ConclusionsThe 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.

KW - 3123 Gynaecology and paediatrics

KW - Estradiol

KW - Hormone therapy

KW - Menopause

KW - Stress urinary incontinence

KW - FREE VAGINAL TAPE

KW - ESTROGEN

KW - MENOPAUSE

KW - ESTRADIOL

U2 - 10.1007/s00192-018-3682-7

DO - 10.1007/s00192-018-3682-7

M3 - Article

VL - 30

SP - 251

EP - 256

JO - International Urogynecology Journal

JF - International Urogynecology Journal

SN - 0937-3462

IS - 2

ER -