Menopausal transition and the risk of urinary incontinence: results from a British prospective cohort

Abstract

Objective: to investigate the effect of menopausal transition and age on symptoms of urinary incontinence in midlife.

Subjects and methods: the study included a nationally representative cohort of 1211 women followed up since their birth in 1946 and annually from 48-54 years; their menopausal transition status and symptoms of stress, urge, and severe urinary incontinence (UI) at 7 consecutive years from ages 48-54 were assessed.

Results: from Generalized Estimating Equations, women who became perimenopausal ('pre-peri') or those experiencing perimenopause for >1 year ('peri-peri') were more likely to have symptoms of stress UI than were postmenopausal women; the odds ratio (95% confidence interval) was; pre-peri 1.39 (1.11-1.73); and peri-peri 1.39 (1.4-1.71). Menopausal transition status was not associated with urge or severe UI. These relationships were not explained by age, childhood enuresis, reproductive factors, previous health status, body mass index and educational qualifications.

Conclusion: this study is unique in being able to disentangle the effects of age, menopausal transitions, and other life-long risk factors on UI. Menopausal transition was only related to stress UI, while increasing age was related to both stress and urge UI. This study suggests that there are both shared and distinct aetiological pathways leading to each type of UI.

FIG. 1

The percentage of 843 women in each menopausal transition category with stress UI, by age; for parsimony, only a few categories were selected for illustrative purposes