Worsening incontinence not linked to menopause

NEW YORK (Reuters Health) - The worsening of symptoms of incontinence among middle-aged women is attributable to weight gain, not menopause, according to findings published in the journal Obstetrics and Gynecology.

Previous studies have found a higher rate of urinary incontinence in women ages 45 to 55 years, coinciding with the menopause transition, note Dr. L. Elaine Waetjen, of the University of California, Davis, and colleagues. This increase in incontinence in midlife has been explained, in part, by urinary tract changes associated with the loss of estrogen during menopause.

The researchers examined the validity of this explanation by analyzing data from 2,415 women who reported episodes of incontinence monthly or more often at study enrollment and during the first six annual follow-up visits (1995 to 2002) of the Study of Women's Health Across the Nation.

Worsening incontinence was defined as an increase in the frequency and improving incontinence was defined as a decrease in the frequency between annual visits. Questions assessing menstrual bleeding patterns were used to classify the menopausal status annually of the women not on hormone therapy.

Overall, 14.7 percent of incontinent women reported worsening incontinence over 6 years. Improvement was reported by 32.4 percent of women, and no change in the frequency of symptoms was reported by 52.9 percent.

As noted, the transition through menopause did not significantly affect the severity of incontinence symptoms. By contrast, weight gain was associated with worsening incontinence.

"Many women and clinicians have believed urinary incontinence to be a symptom attributable to the menopausal transition, but our results suggest that the transition...has either no effect or possibly a weak positive effect on changes in the frequency of incontinence symptoms in midlife women," Waetjen and colleagues conclude.

SOURCE: Obstetrics and Gynecology, March 2008.