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Associations between serum testosterone levels and overactive bladder in women: a cross-sectional research of NHANES 2011 to 2016

  • Urology - Original Paper
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Abstract

Purpose

Androgen receptors are expressed in the pelvic floor and lower urinary tract. However, the association between serum testosterone and overactive bladder (OAB) in women remains unclear. This study aimed to investigate their association in a nationally representative population.

Methods

In this cross-sectional study, we collected data on female participants older than 20 years with serum total testosterone measurements and OAB questionnaires from the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression models were used to analyze the relationship between testosterone and OAB in women.

Results

Data on 4991 women was analyzed in this study, of whom 25.9% had OAB symptoms. Women with lower serum testosterone had an increased frequency of urge urinary incontinence and nocturia compared to participants with enough testosterone. The multivariate logistic models showed that those women with a testosterone level less than 18.5 ng/dL had significantly higher odds of OAB compared to those with a testosterone level greater than 18.5 ng/dL [OR 95% CI = 1.271 (1.073–1.505), P = 0.0076]. Separate interaction analyses revealed no significant effect of age, BMI, diabetes, education, alcohol use and menopause on the association between serum testosterone and OAB. Sensitivity analyses demonstrated that additional variables (depression, stroke and stress urinary incontinence) had no significant effect on this relationship.

Conclusions

Low serum testosterone is associated with an increased likelihood of OAB in women. This supports the potential therapeutic role of testosterone supplementation in women with OAB. Given the direct and indirect effects of testosterone on the pelvic floor and lower urinary tract, a potential mechanism for this relationship can be further explored in translational studies.

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Data availability

The datasets generated during and/or analyzed during the current study are publicly available. This data can be found here: The National Health and Nutrition Examination Survey dataset at https://www.cdc.gov/nchs/nhanes/index.htm

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Acknowledgements

We are grateful to the staff of NHANES, as well as the participants involved in this study. And we are very grateful to the reviewers of our manuscript. We appreciate the providers of the grants, and they were not involved in the writing of this manuscript.

Funding

This study was funded by the National Natural Science Foundation of China (grant numbers: 82170786 and 81670688 to XZ, 81800666 to BL) and the Natural Science Foundation of Guangdong Province (grant numbers: 2023A1515010422 to BL and 2022A1515010250 to XZ).

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Author notes

  1. Wenshuang Li, Junlong Huang and Jialiang Chen have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Wenshuang Li, Junlong Huang, Jialiang Chen, Chi Zhang, Ruixiang Luo, Bolong Liu & Xiangfu Zhou

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  1. Wenshuang Li
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  2. Junlong Huang
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Contributions

WL, JH and JC: analyzed and interpreted the participants’ data and drafted the manuscript. RL and CZ: performed statistical analysis and substantively revised the manuscript for scientific and factual content. XZ and BL: conducted the conception and design of the work. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Bolong Liu or Xiangfu Zhou.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval and consent to participate

The Research Ethics Review Board of the National Center for Health Statistics approved this study, and participants provided written informed consent to participate.

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Li, W., Huang, J., Chen, J. et al. Associations between serum testosterone levels and overactive bladder in women: a cross-sectional research of NHANES 2011 to 2016. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03996-9

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