To elucidate the association of endogenous circulating testosterone and its related substances with the onset and severity of stress urinary incontinence (SUI) in postmenopausal women.

A comparative analysis of clinical data was conducted on postmenopausal women with SUI who visited our hospital between January 2021 and October 2025, along with age-matched healthy postmenopausal controls recruited during the same period. Participants were stratified by age and body mass index (BMI). Venous blood samples were collected from all subjects, and serum levels of testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone (DHEA), and androstenedione were measured using chemiluminescence immunoassay. After adjusting for age, BMI, hypertension, delivery mode, hysterectomy status, and occupation, multivariate logistic regression analysis was performed to determine the relationship between SUI in postmenopausal women and serum testosterone and its related substances.

Serum testosterone levels were significantly lower in SUI patients compared to healthy controls (1.05 ± 0.60 vs 1.76 ± 0.93; P < .05), while no significant differences were observed in SHBG, DHEA, or androstenedione levels between groups ( P > .05). Decreased serum testosterone levels not only showed a negative correlation with SUI severity in postmenopausal women, but also emerged as a potential risk factor for SUI ( OR = 5.627, 95% CI = 3.360-9.424, P = .001). In contrast, SHBG, DHEA, and androstenedione showed no significant correlation ( P > .05).

The findings of this study suggest that low serum testosterone levels are associated with an increased likelihood of SUI in postmenopausal women.