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Stress urinary incontinence and the forgotten female hormones

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A Correction to this article was published on 19 May 2022

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Abstract

The use of hormones to treat stress urinary incontinence (SUI) has fallen out of favor because of concerns over safety following publication of the Women’s Health Initiative study. In addition, there are data that suggest that estrogen treatment does not help SUI. As women age, the decline in androgen output mirrors the increasing prevalence of SUI implying a potential causal association. Therefore, we suggest that androgens are the ‘forgotten female hormone.’ Vaginal estrogens can treat pelvic floor structures without significant systemic effects; we suggest that vaginal androgens can act similarly and thereby avoid the unwanted systemic effects of androgenization in women. Based on available preclinical and clinical data, we suggest that research should investigate vaginal treatment with androgen hormones as adjunctive therapy to pelvic floor exercises for SUI. In a postmenopausal woman, this could be supplemented with estrogens if trial data warrant it.

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Authors and Affiliations

  1. Gholdenphish Ltd, London, UK

    Nicholas Siddle

  2. Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA

    Eboo Versi

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  1. Nicholas Siddle
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  2. Eboo Versi
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N C Siddle: Development of concept, manuscript writing and editing

E Versi: Development of concept, manuscript writing and editing

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Correspondence to Eboo Versi.

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Dr Siddle is owner at Gholdenphish Ltd.; Dr. Versi is a consultant for Hologic Inc.

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The original online version of this article was revised: During production, the name “Rutgers Robert” was inadvertently captured as one of the authors of this article, which is not correct. This name “Rutgers Robert” is part of the 2nd affiliation.

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Siddle, N., Versi, E. Stress urinary incontinence and the forgotten female hormones. Int Urogynecol J 33, 1711–1716 (2022). https://doi.org/10.1007/s00192-022-05178-6

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  • DOI: https://doi.org/10.1007/s00192-022-05178-6

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