The relation between urinary incontinence and steroid hormone levels in perimenopausal women. A report from the Women's Health in the Lund Area (WHILA) study

Objective. To outline possible associations between urinary incontinence (UI) and serum levels of steroid hormones in middle‐aged women. Design and setting. Community‐based observational study. Sample. All women aged 50–59 living in the Lund area by December 1995 were invited to a screening procedure. Sixty‐four percent ( n = 6,917) attended the screening that included physical and laboratory examinations and questionnaires. Methods. Serum levels of cortisol, testosterone, androstendione, SHBG (sex hormone‐binding globulin), and estradiol were analyzed and the 2,221 (32%) women who reported urinary leakage causing a social or hygienic problem were compared to those who denied incontinence. Main outcome measure. Possible differences in serum levels of steroid hormones in continent and incontinent women. Results. There were no significant differences between continent and incontinent women regarding serum levels of cortisol, testosterone, androstendione, or testosterone + androstendione combined. Serum estradiol adjusted for body mass index, parity, smoking, and hysterectomy was significantly higher in incontinent women (87.1±138.4 pmol/l vs. 78.0±118.5 pmol/l, p = 0.005), whereas the ratio estradiol/SHBG was not. These differences persisted when the group of women not on hormonal treatment was analyzed. Conclusions. UI in middle‐aged women seems related to higher serum estradiol levels. This corroborates with studies showing a higher incidence and/or prevalence of UI in women on hormone therapy. No association between UI and serum levels of cortisol, testosterone, or androstendione wasfound.