Hormones and Urological Health: What Every Man and Woman Should Know

By Dr. David Samadi

Hormones are vital to nearly every system in the body, and the urinary and reproductive systems are no exception. For both men and women, hormonal changes can directly impact bladder control, pelvic muscle strength, nerve sensitivity, and sexual health. Understanding how these hormones function—and how shifts in their levels affect urological health—can help patients and providers better manage common concerns like incontinence, overactive bladder, erectile dysfunction, and changes in libido.

The Role of Hormones in Urological Function

Hormones act as chemical messengers, regulating critical functions throughout the body. In the context of urological health, they influence blood flow, tissue integrity, nerve signaling, and the tone of muscles that support the bladder and pelvic organs. When hormone levels become imbalanced—due to aging, medical conditions, or life stages such as menopause or andropause—urological symptoms often emerge.

Men’s Urological Health: The Influence of Testosterone

Testosterone is the primary sex hormone in men, playing a key role not only in reproductive health but also in the maintenance of muscle mass, bone density, and urinary function.

Common urological issues linked to declining testosterone include:

• Reduced sexual function: Low testosterone is associated with decreased libido and erectile dysfunction (ED).
• Prostate enlargement (BPH): As men age, changes in testosterone and its metabolite, dihydrotestosterone (DHT), can lead to benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that can interfere with normal urine flow.
• Pelvic floor muscle weakness: Testosterone contributes to the strength of pelvic muscles. A decline can affect muscle tone, increasing the risk of urinary leakage or urgency.

Women’s Urological Health: Estrogen’s Critical Role

In women, estrogen has a vital and protective part a woman’s health of her urinary tract and pelvic floor. As women go through perimenopause and menopause, estrogen levels naturally decline, often leading to urological changes that can affect quality of life.

Key impacts of low estrogen include:

• Urinary incontinence: Estrogen supports the tissues and muscles of the pelvic floor. As levels drop, women may experience stress incontinence (leaking during coughing, laughing, or exercise).
• Overactive bladder: Estrogen helps regulate nerve function and blood flow in the bladder. Lower levels may result in urgency, frequency, and nocturia.
• Vaginal and urethral tissue changes: Declining estrogen can cause dryness and thinning of vaginal and urethral tissues, increasing discomfort and the risk of urinary tract infections (UTIs).

Conditions Commonly Associated with Hormonal Imbalance

Several urological conditions are influenced by hormonal fluctuations:

• Benign Prostatic Hyperplasia (BPH): Common in aging men, BPH can cause slow or difficult urination, urinary retention, and increased nighttime urination.
• Urinary Incontinence: Stress or urgency incontinence often occurs in women due to estrogen loss and may also affect men with weak pelvic muscles.
• Erectile Dysfunction (ED): Testosterone deficiency is a known contributor to ED.
• Overactive Bladder (OAB): Frequently seen in women after menopause, OAB involves a sudden, urgent need to urinate and, in some cases, leakage.

Treatment Options: Supporting Hormonal and Urological Health

If hormone-related urological symptoms are affecting daily life, several evidence-based treatment options are available.

Hormone Therapy

• Testosterone Replacement Therapy (TRT): For men with clinically low testosterone, TRT can improve energy, libido, and sexual performance, and may indirectly support better urinary function.
• Estrogen Therapy: Local or systemic estrogen replacement can help women improve pelvic floor support, reduce overactive bladder symptoms, and maintain tissue integrity.

Pelvic Floor Strengthening

• Kegel exercises: These simple, targeted exercises help strengthen the pelvic muscles and are beneficial for both men and women in managing urinary symptoms.
• Pelvic floor physical therapy: A specialized physical therapist can provide structured rehabilitation to improve muscle control and reduce incontinence or pelvic pain.

Medical and Non-Surgical Interventions

• Medications for BPH: Alpha-blockers and 5-alpha reductase inhibitors help reduce prostate size or relax the muscles around the bladder and prostate to ease urination.
• Botulinum toxin (Botox) injections: Approved for treating overactive bladder, this approach reduces bladder muscle contractions that cause urgency and frequency.
• Laser and regenerative therapies: Women experiencing vaginal dryness or laxity may benefit from non-surgical laser treatments that support tissue health and urological comfort.

When to Seek Medical Guidance

As we age, hormonal shifts are natural and to be expected, but persistent urinary or sexual health concerns should not be ignored. If you’re noticing symptoms like frequent urination, incontinence, ED, or vaginal dryness, consult with a urologist or hormone specialist. The earlier a person seeks helps, the greater likelihood of preventing complications and continuing to lead a good quality of life.

Conclusion

Hormones are powerful regulators of urological health. When men and women recognize the signs of hormonal imbalance and seek out exploring treatment options early on, this sets them on a path to meaningful steps toward maintaining bladder control, sexual wellness, and overall well-being.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.