Life course influences on women's urinary symptoms and their management during the menopause transition: a prospective birth cohort study. (360G-Wellcome-078486_Z_05_Z)

The MRC National Survey of Health and Development (NSHD) is a nationally representative sample of 2547 women and 2815 men followed up regularly since their birth in March 1946. We shall use repeated data on urinary incontinence collected annually from women study members between the ages of 48 and 54 years, together with life course data on development, health and circumstances, to study the effects of childhood enuresis phenotypes, lifetime weight trajectories and timing of menopausal transition on urge and stress incontinence. Previous, mainly cross sectional studies, focused on adult risk factors, and could not distinguish the effects of menopause from those of age. We shall examine whether changes in urinary symptoms impact on quality of life, independent of potential confounders. We shall study the management strategies that women adopt to relieve urinary symptoms, identifying long-term socioeconomic, behavioural, and health characteristics that distinguish between various management strategies, and between those who seek help or not. This life course study will advance aetiological understanding of midlife incontinence and help clinicians tailor treatment strategies to an individual woman's risk profile. It will inform policy for well-timed interventions designed to improve quality of life for women as they negotiate the menopausal years.