Can Low Testosterone Cause Overactive Bladder in Women?

Many of us are unaware of the significant impact that low testosterone levels can have on our health, but particularly in relation to our bladder function. This connection may be a bit of a surprise given we usually associate testosterone with male health and libido, so if you are wondering about the role it plays in women’s wellbeing, you won’t be alone.

In fact, low testosterone may be a contributing factor for overactive bladder (OAB). OAB is a condition characterised by a sudden and uncontrollable urge to urinate, and many women experience leaks as a result of OAB. It’s a frustrating and often embarrassing problem that affects many of us and especially as we go through menopause and as we age.

New and recent studies have shed light on a potential link between low testosterone levels and the prevalence of OAB in women and for those of us navigating perimenopause, or who experience hormone imbalance, it can be useful to be aware new developments in research to help manage OAB. 

What is Overactive Bladder (OAB)?

Firstly, let’s understand exactly what OAB is. Overactive bladder is a condition that involves a frequent and sudden urge to urinate, which can be difficult to control. This urgency can sometimes lead to urge incontinence, where there is an unintentional loss of urine. OAB can impact our everyday activities, limit social interactions as we need to be constantly near a loo, and affect our overall quality of life.

The exact cause of OAB isn’t always clear, but it’s often associated with the muscles in the bladder contracting involuntarily. These involuntary contractions can occur even when the bladder isn’t full, leading to that familiar urgency to pee. Factors like ageing, hormonal changes, nerve damage, and even certain medications can contribute to the development of OAB.

What is the role of testosterone in women’s health?

While we most commonly associate testosterone with men’s health, it is equally important for women. It is produced in small amounts by our ovaries and adrenal glands and is important for maintaining bone density, muscle mass, mood, and overall energy levels. It also plays a role in our sexual health, influencing libido and sexual function.

We are also starting to understand more about how testosterone levels affect other aspects of women’s health, including urinary and bladder function. As we age, our hormone levels naturally fluctuate, and a decline in testosterone is common for many of us. This decline can have a serious impact on our bladder health and be an underlying cause of leaks and urgency. 

Current research into the link between low testosterone and OAB

It’s important to note that the connection between low testosterone and OAB is a relatively new area of research. One piece of research, that was part of the Health ABC study, showed that older women with decreased levels of serum testosterone are more likely to experience incontinence. However, the study author noted that these findings didn’t necessarily mean that urologists should give testosterone to every woman experiencing OAB, but rather use this information to understand the role of hormone levels on the bladder as we age.

Another study, which analysed data from nearly 5,000 women, found that those with insufficient testosterone levels were more likely to experience symptoms of OAB and proposed that low testosterone might lead to weaker pelvic floor muscles and impact the smooth muscle function of the bladder, contributing to the development of OAB.

Please note that while this insight could be positive for women's health, further research and clinical studies are required to support the findings in these studies.

Why might low testosterone lead to OAB? 

One possible explanation lies in the role of testosterone in maintaining muscle strength and function. Testosterone helps keep our pelvic floor muscles, which support the bladder and urethra, strong and functional. When testosterone levels drop, these muscles can weaken, potentially leading to bladder control issues. 

Testosterone might also have a direct effect on the bladder’s smooth muscle tissue, helping to regulate its contractions. Lower levels of testosterone could therefore contribute to the involuntary contractions seen in OAB.

What should you look out for?

Identifying the symptoms of low testosterone can be challenging, as they often overlap with other common health issues, especially those related to ageing. It’s important to discuss any concerns that you have with your GP for advice and management of OAB.

Some symptoms to watch out for and discuss with your GP include:

• Decreased energy levels

• Reduced libido or sexual dysfunction

• Muscle weakness or loss of muscle mass

• Mood changes, such as increased irritability or depression

• Difficulty concentrating or memory

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