Urinary Lignans are Associated with Decreased Incontinence in Postmenopausal Women

OBJECTIVE - To examine the association between urinary phytoestrogens and self-reported urinary incontinence in post-menopausal women in the United States using a large, cross-sectional, population based cohort survey.

METHODS - Data were analyzed for 1,789 post-menopausal women 50 years of age or older who participated in one of the 2001 to 2010 cycles of National Health and Nutrition Examination Survey and underwent measurement of four isoflavone (soy-derived) and two lignan (flax-derived) phytoestrogens in their urine. Incontinence was defined as self-reported stress, urge, other or mixed incontinence. Urine phytoestrogen concentrations were examined in weighted, multivariate logistic regression models for association with each of the lower urinary tract symptoms. All models were adjusted for age, body mass index, diabetes, race, smoking and parity.

RESULTS - Increasing urine concentrations of the lignan phytoestrogen enterodiol was associated with decreased likelihood of urge (OR 0.92, 95% CI 0.85-0.99), mixed (OR 0.90, 95% CI 0.82-0.98) and other (OR 0.90, 95% CI 0.81-0.99) incontinence, while increasing urine concentrations of the lignan phytoestrogen enterolactone was associated with decreased likelihood of urge (OR 0.92, 95% 0.86-0.99) and mixed (OR 0.91, 95% CI 0.84-0.99) incontinence. No association was observed between any isoflavone phytoestrogens and types of incontinence.

CONCLUSIONS - This study demonstrates that lignan phytoestrogens may have a protective effect against incontinence in post-menopausal women. Prospective clinical and laboratory studies are warranted to investigate the mechanism of this relationship.

Urology. 2015 Jul 29. pii: S0090-4295(15)00705-0. doi: 10.1016/j.urology.2015.07.024. [Epub ahead of print]

Kreydin EI1, Kim MM2, Barrisford GW2, Rodriguez D2, Sanchez A2, Santiago-Lastra Y2, Ko DS2.

1 Department of Urology, Massachusetts General Hospital, Boston, MA.
2 Department of Urology, Massachusetts General Hospital, Boston, MA.

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