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Sex Hormone-Binding Globulin in Postmenopausal Women With Urinary Incontinence
Marie E Sullivan1, Joni K Evans2, Amr El Haraki1
1Departments of Urogynecology and Pelvic Reconstructive Surgery.
Urogynecology (Philadelphia, Pa.)
|March 19, 2026
Summary
Higher sex hormone-binding globulin (SHBG) and lower free estrogen and testosterone are linked to urgency urinary incontinence (UUI) in postmenopausal women. This suggests bioavailable hormones are crucial for genitourinary health.
Area of Science:
- Endocrinology
- Urology
- Women's Health
Background:
- Urinary incontinence (UI) is a common issue in postmenopausal women.
- Sex hormone-binding globulin (SHBG) affects the bioavailability of estrogen and testosterone.
- Low testosterone and estrogen levels are potentially linked to UI.
Purpose of the Study:
- To investigate the relationship between UI and SHBG levels, bioavailable estrogen, and testosterone in postmenopausal women.
- To determine if higher SHBG levels correlate with increased likelihood of urgency and stress UI.
Main Methods:
- Cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data (2013-2016).
- Serum measurements of SHBG, estradiol, and testosterone.
- Calculation of bioavailable hormones using hormone/SHBG ratios and logistic regression analysis.
Main Results:
- Higher SHBG levels were significantly associated with urgency urinary incontinence (UUI).
- Women with UUI had significantly lower levels of free estrogen and free testosterone.
- Increased SHBG levels (≥65 nmol/L) correlated with a 1.37-fold increased odds of experiencing UUI.
Conclusions:
- Elevated SHBG and diminished free estrogen/testosterone are linked to UUI in postmenopausal women.
- Bioavailable hormone levels play a critical role in maintaining genitourinary tract function.
- Further research into hormone replacement therapy targeting bioavailable hormones may be beneficial.
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