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Postmenopausal hormone therapy and risk of developing urinary incontinence
Francine Grodstein1, Karen Lifford, Neil M Resnick
1Channing Laboratory and Renal Division, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA. fran.grodstein@channing.harvard.edu
Obstetrics and Gynecology
|February 3, 2004
Summary
Postmenopausal hormone therapy increases the risk of developing urinary incontinence. Cessation of hormone use diminishes this risk, with no increased risk observed 10 years after stopping.
Area of Science:
- Gynecology
- Urology
- Epidemiology
Background:
- Urinary incontinence is a common condition affecting postmenopausal women.
- Hormone therapy is frequently used to manage menopausal symptoms.
Purpose of the Study:
- To investigate the association between postmenopausal hormone therapy and the incidence of urinary incontinence.
Main Methods:
- A longitudinal study of 39,436 postmenopausal women from the Nurses' Health Study.
- Assessed hormone use via questionnaires from 1976-1996 and tracked incident incontinence from 1996-2000.
- Logistic regression analysis was used to calculate relative risks (RRs) and 95% confidence intervals (CIs).
Main Results:
- The risk of developing incontinence was elevated for women using postmenopausal hormones (oral estrogen RR 1.54; transdermal estrogen RR 1.68; oral estrogen with progestin RR 1.34; transdermal estrogen with progestin RR 1.46).
- The risk of incontinence was minimal after hormone cessation and decreased with time since last use.
- Ten years after stopping hormone therapy, the risk of incontinence was similar to that of women who never used hormones (RR 1.02).
Conclusions:
- Postmenopausal hormone therapy is associated with an increased risk of developing urinary incontinence.
- The increased risk is independent of hormone type, route of administration, or dose.
- Discontinuing hormone therapy reduces the risk of urinary incontinence.