Menopause hormone therapy and urinary symptoms: a systematic review

排尿困难 医学 更年期 尿失禁 激素疗法 泌尿系统 下尿路症状 妇科 低雌激素 泌尿生殖系统 随机对照试验 内科学 膀胱过度活动 激素替代疗法(女性对男性) 乳腺癌 泌尿科 癌症 替代医学 病理 前列腺 睾酮(贴片)
作者
Monica Christmas,Shilpa Iyer,Cassandra Daisy,Sumiko Maristany,Juraj Letko,Martha Hickey
出处
期刊:Menopause [Ovid Technologies (Wolters Kluwer)]
卷期号:30 (6): 672-685 被引量:11
标识
DOI:10.1097/gme.0000000000002187
摘要

Abstract Importance Urogenital changes associated with menopause are now classified as genitourinary syndrome of menopause (GSM), which includes symptoms of urgency, frequency, dysuria, and recurrent urinary tract infections for which the recommended treatment is estrogen. However, the association between menopause and urinary symptoms and the efficacy of hormone therapy for these symptoms is uncertain. Objective Our objective was to define the relationship between menopause and urinary symptoms including dysuria, urgency, frequency, recurrent urinary tract infections (UTIs), and urge and stress incontinence by conducting a systematic review of the effects of hormone therapy (HT) for urinary symptoms in perimenopausal and postmenopausal women. Evidence Review Eligible studies included randomized control trials with perimenopausal and postmenopausal women with a primary or secondary outcome of the following urinary symptoms: dysuria, frequent UTI, urgency, frequency, and incontinence, included at least one treatment arm of estrogen therapy, and were in English. Animal trials, cancer studies and pharmacokinetic studies, secondary analyses, and conference abstracts were excluded. PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched until April 2022. Two authors reviewed each article with discrepancies resolved through whole group consensus. Data extracted included the following: publication date, country, setting, subject number, follow-up, duration, age, race/ethnicity, study design, inclusion criteria, and main findings. Findings There is insufficient evidence to confirm that menopause is associated with urinary symptoms. The effect of HT on urinary symptoms depends on type. Systemic HT may cause urinary incontinence or worsen existing urinary symptoms. Vaginal estrogen improves dysuria, frequency, urge and stress incontinence, and recurrent UTI in menopausal women. Conclusions and Relevance Vaginal estrogen improves urinary symptoms and decreases the risk of recurrent UTI in postmenopausal women.
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