Due to a decrease in estrogen, menopause is often accompanied by multiple vaginal and urinary problems. To date, most treatment options focus on vulvar and vaginal atrophy, with fewer options available to treat urinary incontinence. A new study, however, suggests that prasterone is effective in improving the severity of urge urinary incontinence. The results of the study are published online today in Menopausethe journal of the North American Menopause Society (NAMS).
Genitourinary syndrome of menopause (GSM) is defined as a collection of signs and symptoms associated with a decrease in estrogen and other sex steroids involving changes in the labia, clitoris, vagina, urethra and of the bladder. Although some of the symptoms relate to vulvar and vaginal atrophy, others, such as urgency, dysuria, and recurrent urinary tract infections, relate to the urinary system.
A number of moisturizing and lubricating agents are currently available to treat less severe cases of vulvar and vaginal atrophy, while local and systemic hormonal therapies have proven effective in more severe cases. Hyaluronic acid is an example of an effective lubricant often prescribed for this purpose.
When it comes to treating the urinary symptoms of GSM, however, there are fewer options on the market. Systemic hormone therapy, for example, has been shown to have little or no beneficial effect. However, several studies suggest that local administration of vaginal estrogen may improve symptoms of urge incontinence.
Vaginal administration of prasterone (a component of hormone therapy) in the form of pessaries has been shown to be very effective in the treatment of vulvar and vaginal atrophy, but there are few studies demonstrating its effectiveness on urinary symptoms of GSM. A new study aimed to assess the effects of prasterone on symptoms of mild to moderate urinary urgency compared to hyaluronic acid in women with GSM. Urinary urgency occurs when the pressure in the bladder suddenly increases, making it difficult to retain urine.
Although small, this 12-week study supports the hypothesis that prasterone may effectively improve the severity of urge urinary incontinence in women with GSM. Larger studies are needed to draw a firm conclusion on its effectiveness, especially when compared to hyaluronic acid.
The results of the study are published in the article “Prasterone in the treatment of mild to moderate urge incontinence: an observational study”.
“This small observational study showed that vaginal prasterone, which is FDA-approved for the treatment of GSM-related dyspareunia, also helped with urge urinary incontinence. This finding is consistent with studies showing a similar effect vaginal estrogen therapies on urinary incontinence, so prasterone, like vaginal estrogen, can help relieve multiple symptoms of GSM, a common and undertreated condition in middle-aged women,” says Dr. Chrisandra Shufelt , President of NAMS.
Overactive bladder and urinary incontinence worsen with age
Claudia Collà Ruvolo et al, Prasterone in the treatment of mild to moderate urge incontinence: an observational study, Menopause (2022). DOI: 10.1097/GME.0000000000002007
Provided by the North American Menopause Society (NAMS)
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