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 ,Revised 27 June 2008 ,Accepted 1 July 2008.

References 

  1. Farage M, Maibach H. Lifetime changes in the vulva and vagina. Arch Gynecol Obstet. 2006;273:195–202
  2. Saez S, Martin PM. Evidence of estrogen receptors in the trigone area of human urinary bladder. J Ster Biochem. 1981;15:317–320
  3. Batra SC, Iosif CS. Female urethra: a target for estrogen action. J Urol. 1983;129:418–420
  4. Batra SC, Iosif CS. Progesterone receptors in the female lower urinary tract. J Urol. 1987;138:1301–1304
  5. Versi E, Harvey MA, Cardozo L, Brincat M, Studd JW. Urogenital prolapse and atrophy at menopause: a prevalence study. Int Urogynecol J. 2001;12:107–110
  6. Griebling TL, Nygaard IE. The role of estrogen replacement therapy in the management of urinary incontinence and urinary tract infection in postmenopausal women. Endocrinol Metabol Clin N Am. 1997;26:347–360
  7. Hextall A, Cardozo L. The role of estrogen supplementation in lower urinary tract dysfunction. Int Urogynecol J. 2001;12:258–261
  8. Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C, et al. Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005;293:935–948
  9. Milsom I, Ekelund P, Molander U, Arvidsson L, Areskoug B. The influence of age, parity, oral contraception, hysterectomy and menopause on the prevalence of urinary incontinence in women. J Urol. 1993;149:1459–1462
  10. Lichtenstein P, Sullivan PF, Cnattingius S, Gatz M, Johansson S, Carlstrom E, et al. The Swedish Twin Registry in the third millennium: an update. Twin Res Hum Genet. 2006;9:875–882
  11. Hannestad YS, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of incontinence in the county of Nord-Trondelag. J Clin Epidemiol. 2000;53:1150–1157
  12. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–1457
  13. Ezzati M. Comparative quantification of health risks global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization; 2004;
  14. Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L. Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol. 1998;92:722–727
  15. Gebhart JB, Rickard DJ, Barrett TJ, Lesnick TG, Webb MJ, Podratz KC, et al. Expression of estrogen receptor isoforms alpha and beta messenger RNA in vaginal tissue of premenopausal and postmenopausal women. Am J Obstet Gynecol. 2001;185:1325–1331
  16. Rosenzweig BA, Bolina PS, Birch L, Moran C, Marcovici I, Prins GS. Location and concentration of estrogen, progesterone, and androgen receptors in the bladder and urethra of the rabbit. Neurourol Urodynam. 1995;14:87–96
  17. Soderberg MW, Johansson B, Masironi B, Bystrom B, Falconer C, Sahlin L, et al. Pelvic floor sex steroid hormone receptors, distribution and expression in pre- and postmenopausal stress urinary incontinent women. Acta Obstet Gynecol Scand. 2007;86:1377–1384
  18. Palmieri K, Mannikarottu AS, Chichester P, Kogan B, Leggett RE, Whitbeck C, et al. The effects of cyclical oestrogen on bladder and urethral structure and function. BJU Int. 2007;99:171–176
  19. Rud T. The effects of estrogens and gestagens on the urethral pressure profile in urinary continent and stress incontinent women. Acta Obstet Gynecol Scand. 1980;59:265–270
  20. Bhatia NN, Bergman A, Karram MM. Effects of estrogen on urethral function in women with urinary incontinence. Am J Obstet Gynecol. 1989;160:176–181
  21. Bjorling DE, Beckman M, Clayton MK, Wang ZY. Modulation of nerve growth factor in peripheral organs by estrogen and progesterone. Neuroscience. 2002;110:155–167
  22. Ahmed Y, Lin DL, Ferguson C, Esparza N, Damaser MS. Effect of estrogen on urethral function and nerve regeneration following pudendal nerve crush in the female rat. J Urol. 2006;175:1948–1952
  23. Cardozo L, Rekers H, Tapp A, Barnick C, Shepherd A, Schussler B, et al. Oestriol in the treatment of postmenopausal urgency: a multicentre study. Maturitas. 1993;18:47–53
  24. Rufford J, Hextall A, Cardozo L, Khullar V. A double-blind placebo-controlled trial on the effects of 25 mg estradiol implants on the urge syndrome in postmenopausal women. Int Urogynecol J. 2003;14:78–83
  25. Diep N, Constantinou CE. Age dependent response to exogenous estrogen on micturition, contractility and cholinergic receptors of the rat bladder. Life Sci. 1999;64:PL279–PL289
  26. Dambros M, van Koeveringe GA, Bast A, van Kerrebroeck PE. Relaxant effects of estradiol through nongenomic pathways in male and female pig bladder smooth muscle. Pharmacology. 2004;72:121–127
  27. Blakeman PJ, Hilton P, Bulmer JN. Oestrogen and progesterone receptor expression in the female lower urinary tract, with reference to oestrogen status. BJU Int. 2000;86:32–38
  28. Narvekar N, Lakha F, Critchley HO, Glasier AF, Williams AR, Leminen R, et al. Changes in vaginal morphology, steroid receptor and natural antimicrobial content following treatment with low-dose mifepristone. Contraception. 2007;75:271–280
  29. Hextall A. Oestrogens and lower urinary tract function. Maturitas. 2000;36:83–92
  30. Nilsson CG, Haukkamaa M, Vierola H, Luukkainen T. Tissue concentrations of levonorgestrel in women using a levonorgestrel-releasing IUD. Clin Endocrinol. 1982;17:529–536
  31. Milsom I. Longitudinal studies of birth control and pregnancy outcome among women in an urban Swedish population. In:  Glasier A,  Wellings K,  Critchley H editor. Contraception and contraceptive use 2005. London: RCOG Press; 2005;

 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