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 20 June 2018

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News

Menopausal hormone therapy is associated with increased risk of fecal incontinence

The latest issue of Gastroenterology reports that menopausal hormone therapy is associated with increased risk of fecal incontinence in women after menopause.

News image

Low estrogen levels can contribute to development of fecal incontinence in women after menopause by altering neuromuscular continence mechanisms.

However, studies have produced conflicting results on the association between menopausal hormone therapy, and risk of fecal incontinence.

Dr Kyle Staller and colleagues from Massachusetts, USA studied the association between menopausal hormone therapy and risk of fecal incontinence among 55,828 postmenopausal women who participated in the Nurses’ Health Study, were enrolled since 2008, and with no report of fecal incontinence.

The team defined incident fecal incontinence as a report of at least 1 liquid or solid fecal incontinence episode per month during 4 years of follow-up from self-administered, biennial questionnaires administered in 2010 and 2012.

The multivariate hazard ratio for fecal incontinence was 1.26 for past users of menopausal hormone therapy
Gastroenterology

During more than 185,000 person-years of follow-up, the researchers observed 6834 cases of incident fecal incontinence.

Compared with women who never used menopausal hormone therapy, the team found that the multivariate hazard ratio for fecal incontinence was 1.26 for past users of menopausal hormone therapy, and 1.32 for current users.

The research team noted that the risk of fecal incontinence increased with longer duration of menopausal hormone therapy use, and decreased with time since discontinuation.

The team observed an increased risk of fecal incontinence among women receiving MHT that contained a combination of estrogen and progestin compared with estrogen monotherapy.

Dr Staller's team comments, "Current or past use of menopausal hormone therapy was associated with a modestly increased risk of fecal incontinence among postmenopausal women in the Nurses’ Health Study."

"These results support a potential role for exogenous estrogens in the impairment of the fecal continence mechanism."

Gastroenterol 2017: 152(8): 1915–1921.e1
02 June 2017

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