Hormone therapy: a probable solution for postmenopausal women with nocturia

The study is published in the Menopause Journal.

It has been demonstrated that HT improves the causative factors of postmenopausal nocturia, as it has an effect on the most prevalent postmenopausal sleep disorders. However, the literature specifically assessing the effect of HT on nocturia is limited.

Therefore, Pauwaert Kim and colleagues from the Department of Urology, Ghent University Hospital, Belgium conducted this prospective study to observe the impact of different hormonal treatment options on nocturia, its causative factors and bother in postmenopausal women.

The authors recruited a total of 245 postmenopausal women and divided them into four treatment groups based on patient's choice: Estrogen + Progesterone (E+P), Estrogen-only in patients with a prior hysterectomy, tissue-selective estrogen complex (TSEC) and no treatment.

Nocturia and its causative factors were observed using two standardized questionnaires before and after treatment: the International Consultation on Incontinence Questionnaire Nocturia Module and the Targeting the individual's Aetiology of Nocturia to Guide Outcomes (TANGO).

The results of the Targeting the individual's Aetiology of Nocturia to Guide Outcomes were divided in four influencing topics of which the sum score was calculated.

The key findings shown were-

a. A significant reduction in prevalence of nocturia ≥ twice per night was seen after treatment, as the prevalence decreased from 27.7% (59/213) to 16.4% (35/213).

b. Specified per therapy, a significant reduction in nocturnal voiding frequency was observed in patients treated with E+P and TSEC (P = 0.018 and P = 0.018, respectively).

c. This improvement could be explained by a significant reduction in SLEEP sum score in patients treated with E+P and TSEC (P < 0.001, P = 0.013, respectively).

d. Estrogen-only led to a significant change in URINARY TRACT sum score, which is the result of a reduction in urgency prevalence (P = 0.039).

Hence, the authors concluded that "E+P and TSEC treatment led to a significant reduction in nocturia prevalence and bother in women with ≥ 2 nocturnal voids. This effect is mainly the result of improvement in sleep disorders, however an improvement in bladder disorders can be suggested as well. More research is necessary to confirm these findings."