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Postmenopausal hormone therapy: does it cause incontinence?

Jody E Steinauer1, L Elaine Waetjen, Eric Vittinghoff

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA. steinauerrj@obgyn.ucsf.edu

Obstetrics and Gynecology
|November 2, 2005
PubMed
Summary
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Hormone therapy significantly increases the risk of developing both stress and urge urinary incontinence in women. This increased risk of incontinence was observed within four months of initiating treatment.

Area of Science:

  • Women's Health
  • Urology
  • Endocrinology

Background:

  • Hormone therapy is commonly prescribed for menopausal symptoms.
  • The impact of hormone therapy on urinary incontinence requires further investigation.

Purpose of the Study:

  • To evaluate the association between hormone therapy and the incidence of stress and urge urinary incontinence.

Main Methods:

  • A randomized, placebo-controlled, double-blinded trial (Heart Estrogen/progestin Replacement Study) involving 1,208 women.
  • Participants received daily conjugated estrogen plus medroxyprogesterone acetate or a placebo.

Main Results:

  • Women on hormone therapy had a significantly higher risk of weekly incontinence (64%) compared to placebo (49%).

Related Experiment Videos

  • Hormone therapy increased the odds of urge incontinence by 1.5 times and stress incontinence by 1.7 times.
  • Excess risks were 12% for urge and 16% for stress incontinence over 4 years, with numbers needed to harm of 8.6 and 6.2, respectively.

    • Conclusions:

    • Estrogen plus progestin therapy is linked to an increased risk of both urge and stress urinary incontinence.
    • The elevated risk of incontinence emerges within four months of commencing hormone therapy.