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Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy.
- Source :
-
International urogynecology journal [Int Urogynecol J] 2019 Feb; Vol. 30 (2), pp. 251-256. Date of Electronic Publication: 2018 Jun 26. - Publication Year :
- 2019
-
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.<br />Methods: The women with a history of SUI operation (Nā=ā15,002) were identified from the Finnish National Hospital Discharge Register, and the control women without such an operation (Nā=ā44,389) 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.<br />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.<br />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.
- Subjects :
- Estrogen Replacement Therapy methods
Female
Finland epidemiology
Humans
Middle Aged
Postmenopause drug effects
Registries
Risk Factors
Urinary Incontinence, Stress chemically induced
Estradiol adverse effects
Estrogen Replacement Therapy adverse effects
Estrogens adverse effects
Norpregnenes adverse effects
Urinary Incontinence, Stress epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1433-3023
- Volume :
- 30
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- International urogynecology journal
- Publication Type :
- Academic Journal
- Accession number :
- 29946829
- Full Text :
- https://doi.org/10.1007/s00192-018-3682-7