Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI‐RS 2023

Aims This International Consultation on Incontinence‐Research Society report aims to summarize the evidence and uncertainties regarding the use of hormone replacement therapy by any route in the management of lower urinary tract symptoms (LUTS) including recurrent urinary tract infections (rUTI), wi...

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Published in:Neurourology and urodynamics 2024-08, Vol.43 (6), p.1321-1327
Main Authors: Taithongchai, Annika, Mohamed‐Ahmed, Rayan, Sinha, Sanjay, Gibson, William, Giarenis, Ilias, Robinson, Dudley, Abrams, Paul
Format: Article
Language:English
Subjects:
Estrogens
Hormone replacement therapy
Meta-analysis
overactive bladder
Post-menopause
postmenopausal
Primary care
recurrent urinary tract infection
Reviews
systemic estrogen
topical estrogen
urinary incontinence
Urinary tract
Urogenital system
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Summary:Aims This International Consultation on Incontinence‐Research Society report aims to summarize the evidence and uncertainties regarding the use of hormone replacement therapy by any route in the management of lower urinary tract symptoms (LUTS) including recurrent urinary tract infections (rUTI), with a review of special considerations for the elderly. Research question proposals to further this field have been highlighted. Methods An overview of the existing evidence, guidelines, and consensus regarding the use of topical or systemic estrogens in the management of LUTS. Results There are currently evidence and recommendations to offer topical estrogens to postmenopausal women with overactive bladder symptoms as well as postmenopausal women with rUTIs. Systemic estrogens however have been shown in a meta‐analysis to have a negative effect on LUTS and, therefore are not currently recommended. Conclusions Although available evidence and recommendations exist for the use of topical estrogens, few women are commenced on these in primary care. There remain large gaps still within our knowledge of the use of estrogens within the management of LUTS, particularly on when it should be commenced, the length of time treatment should be continued for, and barriers to prescribing.
ISSN:0733-2467
1520-6777
1520-6777
DOI:10.1002/nau.25384