Abstract: PD50-07
Sources of Funding: None

Introduction

Androgen receptors are present in the levator ani and testosterone administration has been shown to result in levator hypertrophy and improvement of surgically induced incontinence in a rodent model.1 However, the association between serum testosterone levels and incontinence in humans has not been extensively studied. We sought to examine the relationship between serum total testosterone levels and self reported urinary incontinence among women participating in a national survey.

Methods

Data were analyzed for 2123 females who participated in the 2012 cycle of National Health and Nutrition Examination Survey and underwent measurement of serum total testosterone. Incontinence was defined as self-reported stress, urge, or mixed incontinence. Serum testosterone concentrations were log-transformed, assigned to quartiles, and examined first in a weighted variance-corrected univariate model for association with incontinence, and then in a weighted variance-corrected model adjusted for age, body mass index, diabetes, race, parity and time of venipuncture (morning, day, or evening).

Results

Univariate analysis revealed a strong inverse correlation between serum testosterone level and each type of incontinence in females. However, after adjustment for age, decreased serum testosterone was associated only with increased likelihood of stress and mixed incontinence. In the multivariate model, women in the lowest quartile of serum testosterone concentration were more likely to complain of stress (OR 1.49, 95%CI 1.07-2.06) and mixed incontinence (OR 1.61, 95%CI 1.18-2.18).

Conclusions

This is the first study to demonstrate a relationship between serum testosterone level and stress and mixed incontinence in women. Given the role of pelvic musculature in maintaining urethral support and the anabolic effect of androgens on skeletal muscle, a physiologic mechanism for this relationship can be proposed and further evaluated in prospective and translational studies.

Funding

None