Association between menopausal transition stages and developing urinary incontinence

L. Elaine Waetjen, Jingjing Ye, Wen Ying Feng, Wesley O. Johnson, Gail A. Greendale, Carolyn M. Sampselle, Barbara Sternfield, Siobàn D. Harlow, Ellen B. Gold

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)989-998
Number of pages10
JournalObstetrics and Gynecology
Volume114
Issue number5
DOIs
StatePublished - Nov 2009

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Waetjen, L. E., Ye, J., Feng, W. Y., Johnson, W. O., Greendale, G. A., Sampselle, C. M., Sternfield, B., Harlow, S. D., & Gold, E. B. (2009). Association between menopausal transition stages and developing urinary incontinence. Obstetrics and Gynecology, 114(5), 989-998. https://doi.org/10.1097/AOG.0b013e3181bb531a