Pilot Clinical Trial Shows Benefits of Hormone Therapy for Nocturia in Postmenopausal Women

A pilot study published in the journal Menopause suggests that postmenopausal women may experience a significant reduction in nocturia—and sleep loss—when treated with hormone therapy.

In this study, which was led by Kim Pauwaert, MD, of Ghent University Hospital, Belgium, 245 patients were assigned to one of four treatment groups:  estrogen with progesterone therapy, estrogen-only for patients with a prior hysterectomy, tissue-selective estrogen complex or no treatment.

At baseline, nocturia affected 26.1% of the entire group (64 of 245 women). Among women who opted for the estrogen and progesterone combination, 24.8% experienced excessive urination at night as compared to 29.8% for women who were treated with estrogen only and 36.4% among women treated with tissue-selective estrogen complex.

After 6 months of hormone therapy, the number of patients who previously woke at least twice per night to urinate dropped from 27.7% at baseline to 16.6%. After treatment, 51.2% of women reported having one or no voids at night as compared to 45.1% of women at baseline. And, 32.4% of patients reported no nighttime voids after treatment as compared to 27.2% at baseline. But 67.7% of women experienced no change in their condition.

“This improvement could be explained by a significant reduction in SLEEP sum score in patients treated with estrogen and progesterone tissue-selective estrogen complex (P < 0.001, P = 0.013, respectively),” write the authors. The estrogen-only group also experienced a significant change in URINARY TRACT sum score due to a reduction in urgency prevalence (P = 0.039).

The authors concluded that this effect can primarily be explained by an improvement in sleep quality, however improvement of bladder dysfunction also may be related to the reduced urgency observed in the study. They recommend that future studies include data from frequency volume charts and renal function profiles.

The authors note that the study has limitations due to the lack of randomization and possible selection bias.

Disclosures: Dr. Pauwaert and Dr. Karel Everaert, MD, declared research financial support from pharmaceutical companies, but none for this particular study.

Reference

Pauwaert K, Goessaert A, Ghijselings L, et al. “Hormone therapy as a possible solution for postmenopausal women with nocturia: results of a pilot trial,” Menopause: The Journal of The North American Menopause Society. March 15, 2021. Vol. 28, No. 5, pp. 000-000. DOI: 10.1097/GME.0000000000001741