Urology. 2003 Oct;62(4 Suppl 1):45-51.
The role of estrogens in female lower urinary tract dysfunction.
Robinson D, Cardozo LD.
Department of Urogynaecology, King's College Hospital, London, United Kingdom. dud@ukgateway.net
The urogenital tract and lower urinary tract are sensitive to the effects of estrogen and progesterone throughout adult life. Epidemiologic studies have implicated estrogen deficiency in the etiology of lower urinary tract symptoms that occur after menopause. Although the role of estrogen replacement therapy in the management of postmenopausal urinary incontinence (UI) remains controversial, its use in the treatment of women with urogenital atrophy is now well established. This review summarizes recent evidence of the urogenital effects of hormone therapy, particularly emphasizing management of postmenopausal UI and recurrent lower urinary tract infections. Estrogen therapy alone has little effect in the management of urodynamic stress UI, although in combination with an alpha-adrenergic agonist, it may improve urinary leakage. Estrogen therapy may be of benefit for the irritative symptoms of urinary urgency, Frequency, and urge UI, although this effect may result from reversal of urogenital atrophy rather than a direct action on the lower urinary tract. The role of estrogen replacement therapy in the treatment of women with recurrent lower urinary tract infections remains to be determined, although there is now some evidence that vaginal administration may be efficacious. Low-dose, vaginally administered estrogens have a role in the treatment of urogenital atrophy in postmenopausal women and appear to be as effective as systemic preparations.
Please click on the required question.
- 1 How is urine produced?
- 2 What is cystitis?
- 3 How prevalent is cystitis?
- 4 What is honeymoon cystitis?
- 5 What are Frequency and nocturia?
- 6 How prevalent are Frequency and nocturia?
- 7 What is urinary incontinence?
- 8 What is stress incontinence of urine?
- 9 What is urgency, urge incontinence and the urge syndrome?
- 10 What causes stress and urge incontinence?
- 11 What is dribbling incontinence?
- 12 How prevalent is urinary incontinence?
- 13 What is the urethral syndrome?
- 14 How can I record my bladder problems and monitor the effects of treatment?
- 15 What simple measures are available to reduce urinary incontinence?
- 16 What are pelvic floor exercises?
- 17 How successful are pelvic floor exercises?
- 18 What is bladder training?
- 19 How effective is bladder training?
- 20 Are there any alternatives to bladder training for urgency symptoms?
- 21 If simple measures do not suffice, what else is available for the treatment of urinary stress incontinence?
- 22 What are urodynamic studies?
- 23 Where can I obtain further information about bladder problems?
- 24 Support Groups.
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