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12-03-2024 | Overactive Bladder | Urology - Original Paper

Associations between serum testosterone levels and overactive bladder in women: a cross-sectional research of NHANES 2011 to 2016

Authors: Wenshuang Li, Junlong Huang, Jialiang Chen, Chi Zhang, Ruixiang Luo, Bolong Liu, Xiangfu Zhou

Published in: International Urology and Nephrology

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Abstract

Purpose

Androgen receptors are expressed in the pelvic floor and lower urinary tract. However, the association between serum testosterone and overactive bladder (OAB) in women remains unclear. This study aimed to investigate their association in a nationally representative population.

Methods

In this cross-sectional study, we collected data on female participants older than 20 years with serum total testosterone measurements and OAB questionnaires from the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression models were used to analyze the relationship between testosterone and OAB in women.

Results

Data on 4991 women was analyzed in this study, of whom 25.9% had OAB symptoms. Women with lower serum testosterone had an increased frequency of urge urinary incontinence and nocturia compared to participants with enough testosterone. The multivariate logistic models showed that those women with a testosterone level less than 18.5 ng/dL had significantly higher odds of OAB compared to those with a testosterone level greater than 18.5 ng/dL [OR 95% CI = 1.271 (1.073–1.505), P = 0.0076]. Separate interaction analyses revealed no significant effect of age, BMI, diabetes, education, alcohol use and menopause on the association between serum testosterone and OAB. Sensitivity analyses demonstrated that additional variables (depression, stroke and stress urinary incontinence) had no significant effect on this relationship.

Conclusions

Low serum testosterone is associated with an increased likelihood of OAB in women. This supports the potential therapeutic role of testosterone supplementation in women with OAB. Given the direct and indirect effects of testosterone on the pelvic floor and lower urinary tract, a potential mechanism for this relationship can be further explored in translational studies.
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Literature
2.
go back to reference Santander J, Plata M, Zuluaga L et al (2022) What is the real burden of the overactive bladder? results from a national prevalence study. Neurourol Urodyn 41:926–934CrossRefPubMed Santander J, Plata M, Zuluaga L et al (2022) What is the real burden of the overactive bladder? results from a national prevalence study. Neurourol Urodyn 41:926–934CrossRefPubMed
3.
go back to reference Kim MK, Shin YS, Lee JH et al (2022) The prevalence of lower urinary tract symptoms and overactive bladder in south Korea: a cross-sectional, population-based study. Int Neurourol J 26:31–36CrossRefPubMedPubMedCentral Kim MK, Shin YS, Lee JH et al (2022) The prevalence of lower urinary tract symptoms and overactive bladder in south Korea: a cross-sectional, population-based study. Int Neurourol J 26:31–36CrossRefPubMedPubMedCentral
4.
go back to reference Al Edwan G, Abdelazim MS, Salhab SE et al (2021) The prevalence of overactive bladder symptoms in women in Algeria, Egypt, Jordan and Lebanon: a cross-sectional population-based survey. Adv Ther 38:1155–1167CrossRefPubMed Al Edwan G, Abdelazim MS, Salhab SE et al (2021) The prevalence of overactive bladder symptoms in women in Algeria, Egypt, Jordan and Lebanon: a cross-sectional population-based survey. Adv Ther 38:1155–1167CrossRefPubMed
5.
go back to reference Ganz ML, Smalarz AM, Krupski TL et al (2010) Economic costs of overactive bladder in the United States. Urology 75(3):526–532CrossRefPubMed Ganz ML, Smalarz AM, Krupski TL et al (2010) Economic costs of overactive bladder in the United States. Urology 75(3):526–532CrossRefPubMed
6.
go back to reference Irwin DE, Mungapen L, Milsom I et al (2009) The economic impact of overactive bladder syndrome in six Western countries. BJU Int 103:202–209CrossRefPubMed Irwin DE, Mungapen L, Milsom I et al (2009) The economic impact of overactive bladder syndrome in six Western countries. BJU Int 103:202–209CrossRefPubMed
7.
go back to reference Chavalmane AK, Comeglio P, Morelli A et al (2010) Sex steroid receptors in male human bladder: expression and biological function. J Sex Med 7:2698–2713CrossRefPubMed Chavalmane AK, Comeglio P, Morelli A et al (2010) Sex steroid receptors in male human bladder: expression and biological function. J Sex Med 7:2698–2713CrossRefPubMed
8.
go back to reference Karazindiyanoğlu S, Cayan S (2008) The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism. Aging Male 11:146–149CrossRefPubMed Karazindiyanoğlu S, Cayan S (2008) The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism. Aging Male 11:146–149CrossRefPubMed
9.
go back to reference Ko YH, Moon DG, Moon KH (2013) Testosterone replacement alone for testosterone deficiency syndrome improves moderate lower urinary tract symptoms: one year follow-up. World J Mens Health 31:47–52CrossRefPubMedPubMedCentral Ko YH, Moon DG, Moon KH (2013) Testosterone replacement alone for testosterone deficiency syndrome improves moderate lower urinary tract symptoms: one year follow-up. World J Mens Health 31:47–52CrossRefPubMedPubMedCentral
10.
go back to reference Celayir S (2003) Effects of different sex hormones on male rabbit urodynamics: an experimental study. Horm Res 60:215–220PubMed Celayir S (2003) Effects of different sex hormones on male rabbit urodynamics: an experimental study. Horm Res 60:215–220PubMed
11.
go back to reference Tek M, Balli E, Cimen B et al (2010) The effect of testosterone replacement therapy on bladder functions and histology in orchiectomized mature male rats. Urology 75:886–890CrossRefPubMed Tek M, Balli E, Cimen B et al (2010) The effect of testosterone replacement therapy on bladder functions and histology in orchiectomized mature male rats. Urology 75:886–890CrossRefPubMed
12.
go back to reference Kallner HK, Elmér C, Andersson K-E et al (2016) Hormonal influence on the effect of mirabegron treatment for overactive bladder. Menopause 23:1303–1306CrossRefPubMed Kallner HK, Elmér C, Andersson K-E et al (2016) Hormonal influence on the effect of mirabegron treatment for overactive bladder. Menopause 23:1303–1306CrossRefPubMed
13.
go back to reference Kwon JK, Kim JH, Choi H et al (2014) Voiding characteristics and related hormonal changes in peri-menopausal and post-menopausal women: a preliminary study. Maturitas 79:311–315CrossRefPubMed Kwon JK, Kim JH, Choi H et al (2014) Voiding characteristics and related hormonal changes in peri-menopausal and post-menopausal women: a preliminary study. Maturitas 79:311–315CrossRefPubMed
14.
go back to reference Sahinkanat T, Ozturk E, Ozkan Y et al (2011) The relationship between serum testosterone levels and bladder storage symptoms in a female population with polycystic ovary syndrome. Arch Gynecol Obstet 284:879–884CrossRefPubMed Sahinkanat T, Ozturk E, Ozkan Y et al (2011) The relationship between serum testosterone levels and bladder storage symptoms in a female population with polycystic ovary syndrome. Arch Gynecol Obstet 284:879–884CrossRefPubMed
15.
go back to reference Zhu S, Wang Z, Tao Z et al (2023) Relationship between marijuana use and overactive bladder (OAB): a cross-sectional research of NHANES 2005 to 2018. Am J Med 136:72–78CrossRefPubMed Zhu S, Wang Z, Tao Z et al (2023) Relationship between marijuana use and overactive bladder (OAB): a cross-sectional research of NHANES 2005 to 2018. Am J Med 136:72–78CrossRefPubMed
16.
go back to reference Blaivas JG, Panagopoulos G, Weiss JP et al (2007) Validation of the overactive bladder symptom score. J Urol 178(2):543–547CrossRefPubMed Blaivas JG, Panagopoulos G, Weiss JP et al (2007) Validation of the overactive bladder symptom score. J Urol 178(2):543–547CrossRefPubMed
19.
go back to reference Wang Y, Xu K, Hu H et al (2011) Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China. Neurourol Urodyn 30:1448–1455CrossRefPubMed Wang Y, Xu K, Hu H et al (2011) Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China. Neurourol Urodyn 30:1448–1455CrossRefPubMed
20.
go back to reference Jo JK, Lee S, Kim YT et al (2012) Analysis of the risk factors for overactive bladder on the basis of a survey in the community. Korean J Urol 53:541–546CrossRefPubMedPubMedCentral Jo JK, Lee S, Kim YT et al (2012) Analysis of the risk factors for overactive bladder on the basis of a survey in the community. Korean J Urol 53:541–546CrossRefPubMedPubMedCentral
22.
go back to reference Kim MM, Kreydin EI (2018) The association of serum testosterone levels and urinary incontinence in women. J Urol 199:522–527CrossRefPubMed Kim MM, Kreydin EI (2018) The association of serum testosterone levels and urinary incontinence in women. J Urol 199:522–527CrossRefPubMed
23.
go back to reference Copas P, Bukovsky A, Asbury B et al (2001) Estrogen, progesterone, and androgen receptor expression in levator ani muscle and fascia. J Womens Health Gend Based Med 10:785–795CrossRefPubMed Copas P, Bukovsky A, Asbury B et al (2001) Estrogen, progesterone, and androgen receptor expression in levator ani muscle and fascia. J Womens Health Gend Based Med 10:785–795CrossRefPubMed
24.
go back to reference Salmi S, Santti R, Gustafsson JA et al (2001) Co-localization of androgen receptor with estrogen receptor beta in the lower urinary tract of the male rat. J Urol 166:674–677CrossRefPubMed Salmi S, Santti R, Gustafsson JA et al (2001) Co-localization of androgen receptor with estrogen receptor beta in the lower urinary tract of the male rat. J Urol 166:674–677CrossRefPubMed
25.
go back to reference Koritsiadis G, Stravodimos K, Mitropoulos D et al (2008) Androgens and bladder outlet obstruction: a correlation with pressure-flow variables in a preliminary study. BJU Int 101:1542–1546CrossRefPubMed Koritsiadis G, Stravodimos K, Mitropoulos D et al (2008) Androgens and bladder outlet obstruction: a correlation with pressure-flow variables in a preliminary study. BJU Int 101:1542–1546CrossRefPubMed
26.
go back to reference Hall R, Andrews PLR, Hoyle CHV (2002) Effects of testosterone on neuromuscular transmission in rat isolated urinary bladder. Eur J Pharmacol 449:301–309CrossRefPubMed Hall R, Andrews PLR, Hoyle CHV (2002) Effects of testosterone on neuromuscular transmission in rat isolated urinary bladder. Eur J Pharmacol 449:301–309CrossRefPubMed
27.
go back to reference Cayan F, Tek M, Balli E et al (2008) The effect of testosterone alone and testosterone + estradiol therapy on bladder functions and smooth muscle/collagen content in surgically menopause induced rats. Maturitas 60:248–252CrossRefPubMed Cayan F, Tek M, Balli E et al (2008) The effect of testosterone alone and testosterone + estradiol therapy on bladder functions and smooth muscle/collagen content in surgically menopause induced rats. Maturitas 60:248–252CrossRefPubMed
28.
go back to reference Fernandes VS, Barahona MV, Recio P et al (2012) Mechanisms involved in testosterone-induced relaxation to the pig urinary bladder neck. Steroids 77:394–402CrossRefPubMed Fernandes VS, Barahona MV, Recio P et al (2012) Mechanisms involved in testosterone-induced relaxation to the pig urinary bladder neck. Steroids 77:394–402CrossRefPubMed
29.
go back to reference Bonilla-Becerra SM, de Oliveira MG, Calmasini FB et al (2017) Micturition dysfunction in four-month old ovariectomized rats: Effects of testosterone replacement. Life Sci 179:120–129CrossRefPubMed Bonilla-Becerra SM, de Oliveira MG, Calmasini FB et al (2017) Micturition dysfunction in four-month old ovariectomized rats: Effects of testosterone replacement. Life Sci 179:120–129CrossRefPubMed
30.
go back to reference Haider A, Gooren LJ, Padungtod P et al (2009) Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men. Andrologia 41(1):7–13CrossRefPubMed Haider A, Gooren LJ, Padungtod P et al (2009) Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men. Andrologia 41(1):7–13CrossRefPubMed
Metadata
Title
Associations between serum testosterone levels and overactive bladder in women: a cross-sectional research of NHANES 2011 to 2016
Authors
Wenshuang Li
Junlong Huang
Jialiang Chen
Chi Zhang
Ruixiang Luo
Bolong Liu
Xiangfu Zhou
Publication date
12-03-2024
Publisher
Springer Netherlands
Published in
International Urology and Nephrology
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-024-03996-9
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