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Incontinence not helped by estrogen therapy
Last Updated: 2005-02-22 16:00:31 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Estrogen is not a useful treatment for a leaky
bladder in postmenopausal women. In fact, this hormone therapy seems to
increase the risk of urinary incontinence in healthy women and worsen it in
those who already have this problem.
Estrogen "with or without progestin should not be prescribed for the
prevention or relief of urinary incontinence," Dr. Susan L. Hendrix, from
Wayne State University in Detroit, and colleagues conclude.
The findings, which appear in the Journal of the American Medical
Association, are based on a study of 23,296 healthy postmenopausal women who
participated in the Women's Health Initiative (WHI) trial.
As part of the WHI trial, the subjects were randomly selected to receive
estrogen plus progestin, estrogen alone, or inactive "placebo". Earlier
results from the WHI trial linked estrogen therapy to an increased risk of
heart attack, stroke, and breast cancer.
Hormone therapy was associated with an increased risk for all types of
urinary incontinence, particularly stress incontinence in which leakage
occurs with actions that raise abdominal pressure, such as laughing or
coughing.
For women who already had urinary incontinence, treatment with either
estrogen or estrogen plus progestin was associated with increasing urinary
frequency. Moreover, such therapy was tied to urinary incontinence that
limited daily activities and reduced quality of life.
In a related editorial, Dr. Catherine E. DuBeau, from the University of
Chicago, comments that Hendrix's team has "performed an important service by
placing urinary incontinence among ranks of other significant women's health
problems that warrant formidable organizational, funding, and analysis
efforts."
SOURCE: Journal of the American Medical Association, February 23, 2005.
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