Aims: Urinary incontinence in general is a major cause of quality of life impairment, morbidity and hospitalization. Its onset is strongly linked to the menopause. Our study aimed to elucidate the possible relationship between endogenous circulating estrogens and the onset and development of stress urinary incontinence (SUI). Methods: One hundred and thirty eight peri-and postmenopausal women with SUI were matched 1: 1 with continent women based on age and BMI. Morning fasting blood samples were drawn from all subjects for assessment of estradiol (E2), FSH, LH, Testosterone, Delta 4-Androstendione (D4A), DHEAS, prolactin, SBHG as well as a biochemical profile (glucose, insulin, triglycerides, cholesterol, HDL, LDL, ApoA1, ApoB). Hormone and biochemical parameters were compared between continent and incontinent women. Results: Incontinent women had significantly lower serum estradiol levels compared to those in the control group (17.30 +/- 8.16 vs. 24.22 +/- 8.99, P<0.001). Furthermore, the same association was observed for serum D4A (146.07 +/- 52.63 vs. 159.99 +/- 42.62, P = 0.017). These associations remained significant after controlling for age, menopausal age, BMI, and number of deliveries. Conclusions: These results may indicate that within the postmenopausal range, endogenous sex hormones may be associated with the presence of SUI in women not on menopausal hormone therapy. (C) 2015 Wiley Periodicals, Inc.