Updated 04 October 2018

Women with lower testosterone levels at higher risk of incontinence

The hormone testosterone is associated with men, but proper testosterone levels in women are just as crucial. In fact, low testosterone levels could increase your chances of urinary incontinence.

The hormone testosterone is seen as the “male” hormone. However, while testosterone may belong to the class of male hormones called androgens, women’s ovaries produce both oestrogen and testosterone.

These hormones need to be in balance in order to achieve optimum wellbeing.

Testosterone in the female body is responsible for:

  • Producing new blood cells
  • Maintaining a healthy sex drive
  • Influencing follicle-stimulating hormones that affect fertility.

Recent research has linked ow testosterone levels in females with urinary incontinence. A study involving 2 123 women showed that the women with the lowest amounts of testosterone had a 48% increased chance of stress incontinence and a 65% higher chance of mixed incontinence (a combination of stress and urge incontinence) than women with higher levels of testosterone.

These findings were presented at the annual meeting of the American Urological Association last year. While the connection between low testosterone and urinary incontinence still needs more research, it is a strong connection and can provide an avenue for treatment. All of this serves to highlight the role of testosterone levels in women. 

What is the link between testosterone and incontinence?

According to Dr Michelle Kim from the Massachusetts General Hospital in Boston, who was part of the study, testosterone levels might be a factor in the prevention of pelvic floor atrophy, which can ultimately lead to incontinence.

According to Dr Kim, androgens such as testosterone have an anabolic effect on skeletal muscles and have been shown to strengthen the muscle structure of the pelvic floor.

Healthy hormone balance can keep incontinence at bay

While low testosterone levels are linked to incontinence, oestrogen also plays a role in keeping the pelvic floor strong and supple. According to The Simon Foundation for Continence, stress incontinence is commonly experienced as a result of loss of tissue strength caused by declining oestrogen levels.

Do you have low testosterone levels?

As we tend to associate testosterone with men, it’s unusual to focus on low testosterone levels as a cause of possible medical problems in women. Here are some signs of low testosterone levels:

  • Sluggishness and fatigue
  • Low sex drive
  • Vaginal dryness
  • Weight gain
  • Trouble sleeping

If you suspect you may have a hormonal imbalance or reduced levels of testosterone, consult your doctor, who will check for problems with your pituitary gland or ovaries, or who will confirm whether you are nearing menopause, which causes a natural depletion of testosterone and oestrogen levels.  

Image credit: iStock


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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