Menopause and Incontinence

Only infrequent incontinence symptoms appear attributable to the menopause, according to researchers who conducted a longitudinal study. Modifiable factors including anxiety, weight gain and diabetes were associated with more frequent incontinence, they found.


Association Between Menopausal Transition Stages and Developing Urinary Incontinence

L. Elaine Waetjen, MD, Jingjing Ye, PhD, Wen-Ying Feng, MS, Wesley O. Johnson, PhD,

Gail A. Greendale, MD, Carolyn M. Sampselle, PhD, RNC, Barbara Sternfield, PhD, Siobàn D. Harlow, PhD, and Ellen B. Gold, PhD, for the Study of Women's Health Across the Nation (SWAN)* 

OBJECTIVE: To estimate whether menopause transition stage is independently associated with the development of incontinence symptoms.

METHODS: We conducted a longitudinal analysis, using discrete proportional hazards models, of women who were continent at baseline in the Study of Women's Health Across the Nation (SWAN), a multicenter, multiracial, multiethnic prospective cohort study of community-dwelling midlife women transitioning through menopause. At baseline and each of the six annual visits, SWAN elicited frequency and type of incontinence in a self- administered questionnaire and classified menopausal

stage from menstrual bleeding patterns.

RESULTS: Compared with premenopause, being in the early perimenopause (incidence 17.8 per 100 woman years) made it 1.34 times and in the late perimenopause (incidence 14.5 per 100 woman years) made it 1.52 times more likely for women to develop monthly or more frequent incontinence.

In contrast, women in postmenopause (incidence 8.2 per 100 woman years) were approximately one half as likely to develop this degree of incontinence. This pattern of association across the menopausal transition was similar for stress and urge incontinence. However, menopausal stage

was not associated with developing more frequent incontinence (leaking several times per week or more). Worsening anxiety symptoms, a high baseline body mass index, weight gain, and new onset diabetes were associated with developing more frequent incontinence.

CONCLUSION: Menopausal transition stage was associated with developing monthly or more frequent but not weekly or more frequent incontinence, suggesting that only infrequent incontinence symptoms were attributable to the perimenopause. Because modifiable factors such as anxiety, weight gain, and diabetes were associated with developing more frequent incontinence, determining

whether healthy life changes and treating medical problems can prevent incontinence is a priority.

Obstet Gynecol 2009;114:989-98

Content Updated 26 October 2009