Hormone therapy may improve nocturia prevalence in post-menopausal women: Study

Belgium: Estrogen plus progesterone (E+P) and tissue-selective estrogen complex (TSEC) treatment significantly reduces bother and nocturia prevalence in postmenopausal women with ≥ 2 nocturnal voids, a recent study has revealed.

The study is published in Menopause, the journal of the North American Menopause Society. 

Nocturia can have a significant impact on a woman's health and quality of life. Hormonal therapy has been successful in treating menopause and its side effects. Kim Pauwaert, Department of Urology, Ghent University Hospital, Belgium, and colleagues aimed to observe the impact of different hormonal treatment options on nocturia, its causative factors, and bother in postmenopausal women. 

The study was a prospective study that recruited 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, 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 into four influencing topics of which the sum score was calculated.

The results of the study were found to be

• A significant reduction was observed in the prevalence of nocturia ≥ twice per night was seen after treatment, as the prevalence decreased from 27.7% (59/213) to 16.4% (35/213), and also nocturnal voiding frequency was observed in patients treated with E+P and TSEC.

• This improvement was explained by a significant reduction in sleep sum score in patients treated with E+P and TSEC.

• Estrogen-only led to a significant change in urinary tract sum score, which is the result of a reduction in urgency prevalence. A significant reduction in the prevalence of nocturia ≥ twice per night was seen after treatment, as the prevalence decreased from 27.7% (59/213) to 16.4% (35/213).

• Specified per therapy, a significant reduction in nocturnal voiding frequency was observed in patients treated with E+P and TSEC. 

• This improvement was explained by a significant reduction in SLEEP sum score in patients treated with E+P and TSEC. Estrogen-only led to a significant change in the URINARY TRACT sum score, which is the result of a reduction in urgency prevalence.

Dr. Pauwaert and team 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."

Reference:

Pauwaert, Kim MD1,2; Goessaert, An-Sofie MD, PhD2; Ghijselings, Lynn MD1,2; Bower, Wendy PhD3; Mariman, An MD, PhD4; Vogelaers, Dirk MD, PhD4; Depypere, Herman MD, PhD5; Everaert, Karel MD, PhD1,2 Hormone therapy as a possible solution for postmenopausal women with nocturia: results of a pilot trial, Menopause: May 2021 - Volume 28 - Issue 5 - p 502-510 doi: 10.1097/GME.0000000000001741