Women - Coping With Sex Hormone Symptoms
Some cancer treatments lower sex hormone levels in the body. The main female sex hormones are oestrogen and progesterone.
Low levels of these sex hormones can sometimes cause urinary problems in women, including urinary tract infections (UTIs) and leaking urine (incontinence).
An important function of oestrogen is to help keep the wall of the urethra elastic and the pelvic floor muscles healthy. The urethra is the tube that takes urine from the bladder to the outside of the body. The pelvic floor muscles surround the lower part of the bladder and urethra.
When the amount of oestrogen in the body drops, it can weaken the muscles and make the urethra less elastic. This can lead to incontinence or infection.
Not everyone who has low levels of sex hormones due to cancer treatment develops urinary problems.
Some research studies suggest that almost 75 out of 100 menopausal women (75%) experience symptoms of incontinence. It also shows that it is the problem they are least likely to seek help for. The reason for this is often that women believed it was normal.
Urinary problems can be difficult to cope with. And it can have an impact on how you feel about yourself and your quality of life.
Speak to your GP or specialist nurse if you are having problems. They are used to talking about these issues and can help you.
A urinary tract infection (UTI) is an infection of any part of the urinary system. It may affect the:
kidneys
the tubes that connect the kidneys with the bladder (ureters)
bladder
the tube that carries urine from the bladder out of your body (urethra)
Symptoms of a UTI include:
a frequent and urgent need to pee
pain or burning when peeing, often when the infection is in the bladder (cystitis)
peeing more often than usual during the night
pain in your tummy (abdomen), your back or sides
blood in your pee
pee that looks cloudy
a high temperature, chills and feeling sick
a very low temperature of below 36C
drink plenty of fluids (about 2 litres a day), particularly water
avoid urine staying in your bladder for too long, pee as soon as you feel you need to
empty your bladder soon after sexual activity
wipe from the front to the back
reduce vaginal dryness
Vaginal dryness can cause irritation in the area of the urethra. This can increase the risk of infection and pain when peeing. There are various ways of reducing vaginal dryness, including oestrogen vaginal creams or lubricants and moisturisers.
Read more about what you can do if you have vaginal dryness
Incontinence can be a symptom of low oestrogen levels. Other causes include:
weight gain
lifestyle changes
diabetes
UTIs (urinary tract infection)
Treatments can include:
bladder training
pelvic floor exercises
medicines
vaginal oestrogen
Bladder training
Bladder training encourages your bladder to hold larger amounts of urine for longer periods of time. You keep a diary of when you go to the toilet and gradually increase the time between each visit.
Pelvic floor exercises
Doing pelvic floor exercises could help to reduce your incontinence. Strengthening and maintaining the pelvic floor muscles might also help with other symptoms, such as:
pelvic pain
pain during sex
Go to the NHS website to learn more about pelvic floor exercises
Medicines
Your doctor might prescribe medication if they are likely to help your symptoms. For example, you might have medicine from a group of drugs called anticholinergics. They help:
to relax the bladder muscle
the bladder to hold more urine before you feel the need to go. This makes it easier to pass urine
Vaginal oestrogen
Research has found that using vaginal oestrogen can help to reduce incontinence and the need to pass urine often and urgently. You can either use a:
cream
gel
vaginal ring - a small plastic ring that is placed inside the vagina and releases hormones
pessary - a small pellet that you put inside your vagina, where it gradually dissolves
tablet - a tablet that you put inside the vagina where it releases oestrogen
Your body will absorb some oestrogen, but the amounts are small. Current research shows that low dose vaginal oestrogen does not seem to increase the risk of breast cancer or a type of womb cancer called endometrial cancer.
Low dose vaginal oestrogen can be used by some people who have hormone dependant cancer, but your doctor will discuss the risk with you. If it is suitable for you, you usually have it under the supervision of your oncologist.
Talk to your GP or specialist nurse to see if this might be an option for you.
There are other things you can do that can help. This includes maintaining your weight and reducing the amount of caffeine you have.
Urinary problems can be difficult to cope with. It's important to tell your doctor or nurse if you are having problems. They will have helped many people with these problems before and can recommend the best treatments for you.
Last reviewed: 29 May 2025
Next review due: 29 May 2028
Cancer treatments can cause changes in sex hormone levels. Symptoms can include hot flushes, memory problems, tiredness, and loss of sex drive.
Some cancer treatments can affect the levels of sex hormones. This can cause a range of different symptoms. But there are things you can do and treatments to help you cope with these changes.
There are organisations to help you cope with symptoms and side effects caused by cancer and its treatment.
About Cancer generously supported by Dangoor Education since 2010. Learn more about Dangoor Education
What to ask your doctor about clinical trials.
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