Pelvic floor training and hormone therapy

Is pelvic floor training beneficial in women who use hormone replacement therapy?

Urinary incontinence is a prevalent condition among women of all ages and has a considerably negative effect on quality of life.

In a recent study1, education about the pelvic floor muscles made women more aware about the pelvic floor muscles' functions and potential dysfunctions, but this was not a substitute for pelvic floor muscle training with a physiotherapist. In a new study, pelvic floor muscle training for post-menopausal women by a physiotherapist significantly increased pelvic floor muscle strength (by 4.5 cmH2O), and significantly decreased the prevalence of urinary incontinence (OR 0.36).

However, these benefits have been observed before and were not the main focus of the new study. Instead, the new study, which involved investigators from Brazil, Australia and Norway, focused on whether the use of hormone replacement therapy had any influence on the amount of benefit obtained from the pelvic floor muscle training.

The mechanism by which systemic combined hormonal therapy could influence the prevalence of urinary incontinence is not well established. 2 high-quality randomised, controlled trials and a systematic review have indicated that hormone therapy increases the risk of both stress and urgency urinary incontinence.

The main indications for prescribing hormone therapy for postmenopausal women are moderate to severe hot flushes, vaginal dryness, fatigue, irritability, sleep disturbance, and depression. Women may wish to consider the pros and cons of hormone therapy with the the findings of this new study in mind.

> From: Ferreira et al., J Physiother 64 (2018) 166-171 . All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.

Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!

Reference in text:

  1. de Andrade RL, Bø K, Antonio FI, Driusso P, Mateus-Vasconcelos EC, Ramos S, Julio MP, Ferreira CH. An education program about pelvic floor muscles improved women’s knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial. J Physiother 2018;64(2):91-6.

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