Cardenas-Trowers Olivia Orlinda, Borgstrom Mark, Addis Ilana
Female Pelvic Med Reconstr Surg. 2018 Mar/Apr;24(2):100-104. doi: 10.1097/SPV.0000000000000493.
The aim of this study was to evaluate the associations between type and route of hormone use and urinary incontinence (UI) and pelvic organ prolapse (POP) in premenopausal and postmenopausal women.
The authors used the National Health and Nutritional Examination Survey database for data from 2005-2006, 2007-2008, 2009-2010, and 2011-2012. Seven thousand sixty-six of the women included were premenopausal, and 5387 were postmenopausal. Premenopausal women were younger than 51 years and reported menstrual periods in the last 12 months. Postmenopausal women reported being in natural or surgical menopause. Urinary incontinence was defined as experiencing urinary leakage "less than once a month" or more. Pelvic organ prolapse was defined as an affirmative response to "experience bulging in the vaginal area." Hormone route and use were stratified in years. Pearson χ and Pearson correlations were used, with P < 0.05 considered significant.
In premenopausal women, birth control pills, estrogen/progestin pills, and estrogen-only patch use are associated with UI (P < 0.05). Birth control pills are associated with both UI and POP in premenopausal women (P < 0.05 for UI and POP). In postmenopausal women, estrogen-only pills, and estrogen/progestin pill use are associated with UI (P < 0.05). Birth control pill use is associated with POP in postmenopausal women (P = 0.029). Neither estrogen patch nor estrogen/progestin patch is associated with UI or POP in postmenopausal women.
Type and route of hormone use have varied associations with UI and POP in premenopausal and postmenopausal women. Prospective studies are needed to further evaluate the effect of hormone type and route on UI and POP in premenopausal and postmenopausal women.
本研究旨在评估绝经前和绝经后女性激素使用类型和途径与尿失禁（UI）及盆腔器官脱垂（POP）之间的关联。
作者使用了2005 - 2006年、2007 - 2008年、2009 - 2010年及2011 - 2012年的美国国家健康与营养检查调查数据库。纳入的女性中，7066名处于绝经前，5387名处于绝经后。绝经前女性年龄小于51岁且在过去12个月有月经来潮。绝经后女性报告处于自然绝经或手术绝经状态。尿失禁定义为每月至少经历一次漏尿。盆腔器官脱垂定义为对“阴道区域有膨出”的肯定回答。激素途径和使用情况按年份分层。采用Pearson χ检验和Pearson相关性分析，P < 0.05为有统计学意义。
在绝经前女性中，口服避孕药、雌激素/孕激素片及仅使用雌激素贴片与尿失禁相关（P < 0.05）。口服避孕药与绝经前女性的尿失禁及盆腔器官脱垂均相关（尿失禁和盆腔器官脱垂的P均< 0.05）。在绝经后女性中，仅使用雌激素片及雌激素/孕激素片与尿失禁相关（P < 0.05）。口服避孕药与绝经后女性的盆腔器官脱垂相关（P = 0.029）。在绝经后女性中，雌激素贴片及雌激素/孕激素贴片均与尿失禁或盆腔器官脱垂无关。
激素使用类型和途径与绝经前和绝经后女性的尿失禁及盆腔器官脱垂存在不同关联。需要进行前瞻性研究以进一步评估激素类型和途径对绝经前和绝经后女性尿失禁及盆腔器官脱垂的影响。
