Background: Urogenital changes associated with menopause are now
classified as genitourinary syndrome of menopause (GSM) which includes
symptoms of urgency, frequency, dysuria, and recurrent urinary tract
infections (UTIs) for which the recommended, treatment is estrogen.
However, the association between menopause and urinary symptoms and the
efficacy of hormone therapy (HT) for these symptoms is uncertain.
Objectives: Our objectives were (1) to define the relationship between
menopause and urinary symptoms including dysuria, urgency, frequency,
recurrent UTIs, and urge and stress incontinence, and 2) to
systematically review the effects of HT for urinary symptoms in peri and
post-menopausal women. Search strategy: PubMed, Scopus, and the Cochrane
Central Register of Controlled Trials (CENTRAL) were searched until
April 2022 Selection criteria: RCTs of peri or postmenopausal women with
urinary symptoms including dysuria, frequent UTI, urgency, frequency,
and incontinence, in English were included. Data collection and
analysis: Two authors reviewed each paper with discrepancies resolved
through whole group consensus. Data extracted included: publication
date, country, setting, subject number, follow-up, duration, age,
race/ethnicity, study design, inclusion criteria, and main findings.
Main results: There is insufficient evidence to confirm that menopause
is associated with urinary symptoms. The effect of HT on urinary
symptoms depends on type. Systemic HT may cause urinary incontinence or
worsen existing urinary symptoms. Vaginal estrogen improves dysuria,
frequency, urge and stress incontinence, and recurrent UTI in
postmenopausal women. Conclusions: Menopause has not been shown to cause
urinary symptoms. Vaginal estrogen improves urinary symptoms and
decreases the risk of recurrent UTI in postmenopausal women.