When people think of menopause, the most frequently mentioned symptoms are hot flashes and night sweats. These have received the lion’s share of research attention and public discourse. However, bladder health and lower urinary tract symptoms (LUTS)—although common—have remained significantly understudied. A new study, published in the journal Menopause, seeks to address this gap by examining the relationship between menopausal status, hormone therapy, and urinary health.
The study, titled “Associations Between Menopausal Status, Hormone Use, and Bladder Health and Lower Urinary Tract Symptoms Among U.S. Women: Findings From the RISE for Health Study,” includes data from over 3,000 women at various stages of the menopausal transition—premenopausal, perimenopausal, and postmenopausal.
The findings reveal several key points. Firstly, it confirms earlier research suggesting that bladder health tends to decline with age, with increased risks of urinary incontinence and infections. Secondly, it sheds light on the controversial role of hormone therapy in urinary health. Systemic hormone therapy appears to be associated with increased rates of urinary incontinence in postmenopausal women, while local, low-dose estrogen treatments may improve genitourinary symptoms and help reduce urinary tract infections.
Importantly, the study introduces new insights into hormone use patterns and their associations with bladder health. Premenopausal women were more likely to report hormone use than their peri- or postmenopausal counterparts, yet showed the smallest differences in bladder health outcomes. By contrast, perimenopausal and postmenopausal women reported worse bladder function and health, particularly when systemic hormone therapy was used.
Researchers concluded that the relationship between menopause, hormone use, and urinary health is complex and multifaceted. They emphasize the need for further research to better understand this connection and advocate for early education programs. By equipping women with knowledge before they enter menopause, they can more easily recognize early warning signs and adopt timely interventions.
“This study reinforces the need for individualized and nuanced approaches to managing urinary health during the menopausal transition,” said Dr. Stephanie Faubion, Medical Director of the Menopause Society.
The study also underscores the importance of integrating urogenital health into the broader conversation on menopause care. While the term Genitourinary Syndrome of Menopause (GSM) was introduced in 2014 by the Menopause Society and the International Society for the Study of Women’s Sexual Health, clinical and public attention has still largely focused on vaginal symptoms such as dryness and pain during intercourse, rather than urinary concerns.
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