Faculty Opinions recommendation of Oestrogen therapy for urinary incontinence in post-menopausal women.

SummaryThe effects on the haemostatic mechanism of oestrogen therapy, given to prevent bone loss in post-menopausal women, have been investigated. Oestriol succinate was given orally to 10 women at a level of 2 mg/day for 1 month and for a further 3 months with incremental increase of 2 mg each month. 6 of the 10 women were subsequently treated with 25 μg/day orally of ethinyl oestradiol. Oestriol succinate therapy resulted in a small increase in the level of factor VII, a decrease in factor VIII concentration and increased sensitivity of platelets to aggregating agents. Ethinyl oestradiol treatment resulted in much more widespread changes with marked increases in coagulation factors VII, VIII, IX and X, decreased levels of antithrombin and dramatic increases in circulating plasminogen levels and euglobulin lysis activity. The data suggested that the nature of oestrogens employed therapeutically is important in determining the qualitative and quantitative effect of oestrogen therapy on components of the haemostatic mechanism.

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Physical Activity, Diet, and Incident Urinary Incontinence in Postmenopausal Women: Women’s Health Initiative Observational Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab118 ◽

2021 ◽

Author(s):

Scott R Bauer ◽

Stacey A Kenfield ◽

Mathew Sorensen ◽

Leslee L Subak ◽

Suzanne Phelan ◽

...

Keyword(s):

Physical Activity ◽

Urinary Incontinence ◽

Observational Study ◽

Weight Change ◽

Protein Intake ◽

Macronutrient Intake ◽

Health Initiative ◽

Menopausal Women ◽

Baseline Weight ◽

Post Menopausal

Abstract Background Physical activity and macronutrient intake, important contributors to energy balance, may be independently associated with female urinary incontinence (UI). Methods We evaluated the association of baseline self-reported physical activity and macronutrient intake, via food-frequency questionnaire, with incident UI subtypes after 3 years among 19,741 post-menopausal women in the Women’s Health Initiative Observational Study. Odds ratios (OR) for incident urgency, stress, and mixed UI were calculated using multivariable logistic regression. Results Women who reported total physical activity (MET-hours/week) ≥30 vs <0.1 were 16% less likely to develop urgency UI (OR=0.84; 95% CI 0.70, 1.00) and 34% less likely for mixed UI (OR=0.66; 0.46, 0.95), although linear trends were no longer statistically significant after adjusting for baseline weight and weight change (P-trend=0.15 and 0.16, respectively). The association between physical activity and incident stress UI was less consistent. Higher uncalibrated protein intake was associated with increased odds of incident urgency UI (≥19.4% versus <14.1% of energy intake OR=1.14; 95% CI 0.99, 1.30; P-trend=0.02), while confidence intervals were wide and included 1.0 for calibrated protein intake. Other macronutrients were not associated with urgency UI and macronutrient intake was not associated with incident stress or mixed UI (P-trend>0.05 for all). Conclusions Among post-menopausal women, higher physical activity was associated with lower risk of incident urgency and mixed UI, but not stress UI, independent of baseline weight and weight change. Higher protein intake was associated with increase urgency UI, but no associations were observed between other macronutrient and UI subtypes.

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