Fertility and Sterility
Volume 92, Issue 2 , Pages 428-433, August 2009

Risk of urinary incontinence symptoms in oral contraceptive users: a national cohort study from the Swedish Twin Register

  • Anastasia Iliadou, Ph.D.

      Affiliations

    • Department of Medical Epidemiology and Biostatistics, Karolinska Institutet Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
    • ,
  • Ian Milsom, M.D., Ph.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
    • ,
  • Nancy L. Pedersen, Ph.D.

      Affiliations

    • Department of Medical Epidemiology and Biostatistics, Karolinska Institutet Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
    • ,
  • Daniel Altman, M.D., Ph.D.

      Affiliations

    • Department of Medical Epidemiology and Biostatistics, Karolinska Institutet Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
    • Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
    • Corresponding Author InformationReprint requests to: Daniel Altman, M.D., Ph.D., Department of Medical Epidemiology and Biostatistics, 171 77 Karolinska Institutet, Stockholm, Sweden (FAX: +46-8-622 58 33).

Received 10 June 2008; received in revised form 27 June 2008; accepted 1 July 2008. published online 14 August 2008.

Objective

To assess the impact of oral contraceptives on lower urinary tract dysfunction in premenopausal women.

Design

Nationwide cohort study.

Setting

National registry.

Patient(s)

A total of 10,791 women (born 1959–1985) from the population- based Swedish Twin Registry who participated in a web-based survey of common diseases.

Intervention(s)

None.

Main Outcome Measure(s)

Symptoms of urinary incontinence.

Result(s)

For users of oral contraception there was a significantly reduced risk for symptoms of stress urinary incontinence, mixed urinary incontinence, and urgency urinary incontinence. The reduction remained significant when adjusting for age, body mass index, and pregnancy history. A reduced prevalence of symptoms of overactive bladder in oral contraceptive users was also observed although the association was nonsignificant. There were no significant associations between lower urinary tract symptoms and women using a levonorgestrel-releasing intrauterine device compared with noncontraceptive users, with the exception of nocturia.

Conclusion(s)

Oral contraceptive use reduces the overall risk for symptoms of urinary incontinence.

Key Words: Contraception, incontinence, overactive bladder, intrauterine device

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 A.I. has nothing to disclose. I.M. is a consultant for Pfizer and United BioSource, an investigator for Pfizer and Astellas, and a lecturer for Pfizer, Astellas, and Novartis. N.P. has nothing to disclose. D.A. is a consultant for Gynecare and a lecturer for Astellas.

 Supported by a grant from the National Institute of Digestive Disorders and Kidney Diseases (U01 DK066134 to N.P.) and a grant from the Nordic Urogynecological Association.

PII: S0015-0282(08)01413-1

doi:10.1016/j.fertnstert.2008.07.002

Fertility and Sterility
Volume 92, Issue 2 , Pages 428-433, August 2009

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