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Review
. 2024 Aug;43(6):1321-1327.
doi: 10.1002/nau.25384. Epub 2024 Jan 30.

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI-RS 2023

Annika Taithongchai  1 , Rayan Mohamed-Ahmed  1 , Sanjay Sinha  2 , William Gibson  3 , Ilias Giarenis  4 , Dudley Robinson  1 , Paul Abrams  5
Affiliations
Review

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI-RS 2023

Annika Taithongchai et al. Neurourol Urodyn. 2024 Aug.

Abstract

Aims: This International Consultation on Incontinence-Research Society report aims to summarize the evidence and uncertainties regarding the use of hormone replacement therapy by any route in the management of lower urinary tract symptoms (LUTS) including recurrent urinary tract infections (rUTI), with a review of special considerations for the elderly. Research question proposals to further this field have been highlighted.

Methods: An overview of the existing evidence, guidelines, and consensus regarding the use of topical or systemic estrogens in the management of LUTS.

Results: There are currently evidence and recommendations to offer topical estrogens to postmenopausal women with overactive bladder symptoms as well as postmenopausal women with rUTIs. Systemic estrogens however have been shown in a meta-analysis to have a negative effect on LUTS and, therefore are not currently recommended.

Conclusions: Although available evidence and recommendations exist for the use of topical estrogens, few women are commenced on these in primary care. There remain large gaps still within our knowledge of the use of estrogens within the management of LUTS, particularly on when it should be commenced, the length of time treatment should be continued for, and barriers to prescribing.

Keywords: hormone replacement therapy; overactive bladder; postmenopausal; recurrent urinary tract infection; systemic estrogen; topical estrogen; urinary incontinence.

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References

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