Hormone Therapy in Postmenopause May Adversely Affect Bladder Health, Research Reveals

“Perimenopausal women were more than twice as likely as premenopausal women to report urgency urinary incontinence and other lower urinary tract symptoms. Both peri- and postmenopausal stages were linked to poorer bladder health scores,” the researchers reported. “Among postmenopausal women, hormone use was associated with a further decline, resulting in a 6-point reduction in Bladder Health Score and a 4.8-point drop in the Bladder Function Index.”

While hot flashes and night sweats are widely recognized as hallmark symptoms of menopause, the impact of hormonal changes on urinary health has not received equal attention. The RISE FOR HEALTH study was designed to fill this gap by examining bladder health across premenopausal, perimenopausal, and postmenopausal women and evaluating how hormone therapy influences these outcomes.

Camille P. Vaughan, Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Emory University, Atlanta, GA, and colleagues surveyed over 3,000 community-dwelling adult women in the United States between May 2022 and December 2023. Researchers assessed bladder health and urinary symptoms using validated tools and conducted multivariable regression analyses to explore associations.

The following were the key findings of the study:

• Perimenopausal and postmenopausal women had significantly poorer bladder health and function compared to premenopausal women.
• Perimenopausal women were over twice as likely (odds ratio 2.27) to report urgency urinary incontinence and other lower urinary tract symptoms.
• Bladder Health Scores (BHS) and Bladder Function Indices (BFI) declined notably with the menopausal transition.
• Hormone use varied across menopausal stages, with 38.3% of premenopausal women reporting use, compared to 21.5% of perimenopausal and 13.2% of postmenopausal women.
• In postmenopausal women, hormone therapy, particularly systemic forms, was linked to poorer bladder outcomes.
• Postmenopausal hormone users showed a 6-point reduction in BHS and a 4.8-point drop in BFI compared to non-users.

These findings confirm earlier reports that urinary symptoms tend to worsen with age and menopause. It also highlights the nuanced and sometimes adverse relationship between hormone use and bladder health in the later stages of menopause.

Researchers concluded that the interplay between hormonal changes and bladder health is multifaceted and warrants greater clinical attention. They emphasized the importance of proactive education and screening for urinary symptoms as women approach menopause. Early recognition and timely interventions may be key in preserving quality of life.

Overall, the study underscores the need for more targeted research and personalized approaches to managing bladder health during the menopause transition—a critical yet often overlooked component of women’s health.

Reference:

Vaughan, Camille P. MD, MS1; Markland, Alayne D. DO, MSc2; McGwin, Gerald PhD3; Lukacz, Emily S. MD4; Brady, Sonya S. PhD, LP5; Lacoursiere, Yvette D. MD, MPH6; Wyman, Jean F. PhD7; Sutcliffe, Siobhan PhD, ScM, MHS8; Smith, Ariana L. MD9; Kenton, Kimberly MD10; Stapleton, Ann MD11; Brubaker, Linda MD12; Harlow, Bernard L. PhD13. Association of menopausal status and hormone use with bladder health and lower urinary tract symptoms in US women: results from the RISE FOR HEALTH study. Menopause ():10.1097/GME.0000000000002541, April 29, 2025. | DOI: 10.1097/GME.0000000000002541