Urinary incontinence not linked to menopause

Contrary to common belief, the worsening of symptoms of urinary incontinence among middle-aged women is not related to menopause. Urinary incontinence (involuntary leakage of urine) is a common and distressing problem, which may have a profound impact on quality of life of older women. Previous studies have found a higher rate of urinary incontinence in women between the age group of 45 to 55 years, coinciding with the menopause transition. This increase in incontinence in women has been partly explained by urinary tract changes associated with the loss of oestrogen during menopause. To assess the association between symptoms of urinary incontinence and menopause, researchers at the University of California analysed data from 2,415 women who reported monthly or more incontinence through questionnaires at baseline and during the first six annual follow-up visits (1995-2002) of the prospective cohort Study of Women's Health Across the Nation. Worsening incontinence was defined as an increase in the frequency and improving incontinence was defined as a decrease in the frequency between annual visits. The researchers evaluated factors associated with improving and worsening incontinence from year to year. Questions assessing menstrual bleeding patterns were used to classify the menopausal status annually of the women not on hormone therapy. The results indicated that 15 percent of incontinent women reported worsening incontinence over 6 years. Improvement was reported by 32 percent of women, and no change in the frequency of symptoms was reported by 52 percent. It was found that the transition through menopause did not significantly affect the severity of incontinence symptoms. By contrast, weight gain was associated with worsening incontinence. Therefore, worsening of incontinence symptoms in older women cannot be attributed to menopause but to modifiable factors such as weight gain.