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Postmenopausal Hormone Therapy: Does It Cause Incontinence?

J. Steinauer, L. E. Waetjen, E. Vittinghoff, L. Subak, S. Hulley, D. Grady, F. Lin, J. Brown
Published 2005 · Medicine

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OBJECTIVE: To estimate the effect of hormone therapy on risk of stress and urge urinary incontinence. METHODS: The Heart Estrogen/progestin Replacement Study was a randomized, placebo-controlled, double-blinded trial to evaluate daily oral conjugated estrogen (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) therapy for the prevention of heart disease events in women with established heart disease. The 1,208 participants in Heart Estrogen/progestin Replacement Study who reported no loss of urine in the previous 7 days at baseline are included in this analysis. RESULTS: During 4.2 years of treatment, 64% of women randomly assigned to hormone therapy compared with 49% of those assigned to placebo reported weekly incontinence (P < .001). The higher risk of incontinence in the hormone group was evident at 4 months, persisted throughout the treatment period, and was independent of the age of the women. The odds ratios for weekly incontinence among women on hormone therapy compared with placebo were 1.5 for urge incontinence (95% confidence interval [CI] 1.2–1.8; P < .001) and 1.7 for stress incontinence (95% CI 1.5–2.1; P < .001). Four years of treatment with hormone therapy caused an excess risk of 12% for weekly urge incontinence and 16% for weekly stress incontinence; the corresponding numbers needed to harm were 8.6 (95% CI 5.8–16.6) and 6.2 (95% CI 4.6–9.4). CONCLUSION: Estrogen plus progestin therapy increases risk of urge and stress incontinence within 4 months of beginning treatment. LEVEL OF EVIDENCE: I
This paper references
The effect of estriol on the cytology of urethra and vagina in postmenopausal women with genito-urinary symptoms.
M. C. van der Linden (1993)
Postmenopausal Hormones and Incontinence: The Heart and Estrogen/Progestin Replacement Study
D. Grady (2001)
A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trøndelag.
Y. Hannestad (2000)
Doppler Velocimetry Parameters of Periurethral Vessels in Postmenopausal Incontinent Women Receiving Estrogen Replacement
M. Girão (2001)
The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence
S. Jackson (2002)
Oestrogen and progesterone receptor expression in the female lower urinary tract, with reference to oestrogen status
P. Blakeman (2000)
The effect of ovariectomy and long-term estrogen replacement on bladder structure and function in the rat.
Nicole Fleischmann (2002)
Effects of estrogen with and without progestin on urinary incontinence.
S. Hendrix (2005)
[Transvaginal estrogen therapy in urinary stress incontinence].
F. Sacco (1990)
Oestriol in the treatment of postmenopausal urgency: a multicentre study.
L. Cardozo (1993)
Treatment with oral piperazine oestrone sulphate for genuine stress incontinence in postmenopausal women
P. Wilson (1987)
Localization of steroid hormone receptors in the pelvic muscles.
P. Smith (1993)
Confidence intervals for the number needed to treat
D. Altman (1998)
The heart and estrogen/progestin replacement study (HERS).
L. Speroff (1998)
Postmenopausal Hormone Therapy and Risk of Developing Urinary Incontinence
F. Grodstein (2004)
Urethral sphincteric insufficiency in postmenopausal females: treatment with phenylpropanolamine and estriol separately and in combination. A urodynamic and clinical evaluation.
H. O. Beisland (1984)
Effects of Oral Estrogen and Progestin on the Lower Urinary Tract Among Female Nursing Home Residents
J. Ouslander (2001)
Changes in urethral cytology following estrogen administration.
A. Bergman (1990)
Effects of estrogen and progestin replacement on the urogenital tract of the ovariectomized cynomolgus monkey
D. Robinson (1996)
Quantitative evaluation of collagen and muscle fibers in the lower urinary tract of castrated and under-hormone replacement female rats.
M. Sartori (2001)
The effect of ovariectomy and estradiol on rabbit bladder smooth muscle contraction and morphology.
K. Aikawa (2003)
Effects of oestradiol and combined norephedrin and oestradiol treatment on female stress incontinence.
A. Ek (1980)
Effect of Estrogen–Progestogen Hormonal Replacement Therapy on Periurethral and Bladder Vessels
R. M. Endo (2000)
Regression models for ordinal responses: a review of methods and applications.
C. Ananth (1997)
Efficacy of Estrogen Supplementation in the Treatment of Urinary Incontinence
J. A. Fantl (1996)
The pelvic floor muscles: Muscle thickness in healthy and urinary‐incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Estrogen receptor studies
I. Bernstein (1997)
Heart and Estrogen/progestin Replacement Study (HERS): design, methods, and baseline characteristics.
D. Grady (1998)
The Effects of Estrogens and Gestagens on the Urethral Pressure Profile in Urinary Continent and Stress Incontinent Women
T. Rud (1980)
The effect of oestrogen supplementation on post‐menopausal urinary stress incontinence: a double‐blind placebo‐controlled trial
S. Jackson (1999)
The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation
A. Hextall (2001)
Clinical outcome and changes in connective tissue metabolism after intravaginal slingplasty in stress incontinent women
C. Falconer (2005)
Power Doppler of the Urethra in Continent or Incontinent, Pre- and Postmenopausal Women
Z. I. K. Jármy-Di Bella (2000)
Estrogen effects on the urethra: beneficial effects in women with genuine stress incontinence.
G. Elia (1993)
Estrogen Therapy in the Management of Urinary Incontinence in Postmenopausal Women: A Meta-Analysis. First Report of the Hormones and Urogenital Therapy Committee
J. A. Fantl (1994)
Paraurethral connective tissue in stress‐incontinent women after menopause
C. Falconer (1998)

This paper is referenced by
Erkrankungen der Urogenitalorgane
J. Marschke (2009)
Kadin İşeme Bozukluklari ve Prolaps Tedavisinde Östrojen'in Yeri
Murat Akand (2014)
Menopausia e incontinencia urinaria femenina: acerca del posible efecto de la terapia hormonal sustitutiva
J. A. Ces (2007)
The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women:2007 position statement of The North American Menopause Society
Lin Shou-qin (2008)
Effects of estrogen, raloxifene, and levormeloxifene on the expression of Rho-kinase signaling molecules in urethral smooth muscle cells.
N. Ning (2010)
Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick?
A. Ewies (2010)
[Psycho-relational aspects of urinary incontinence in female sexuality].
C. Simonelli (2008)
Dose-dependent toxic effects of high-dose estrogen on renal and cardiac injury in surgically postmenopausal mice.
X. Meng (2011)
The biochemistry of wound healing in the pelvic floor: What have we learned?
S. Vishwajit (2009)
Radix Paeoniae Alba increases serum estrogen level and up‐regulates estrogen receptor expression in uterus and vagina of immature/ovariectomized mice
Y. Xu (2019)
Fractional CO 2 Laser Treatment for Vaginal Rejuvenation in Post-Menopausal Indian Women
R. Radhakrishna Pillai (2019)
Ageing of the female pelvic floor: towards treatment a la carte of the “geripause”
D. Rizk (2008)
The potential of hormones and selective oestrogen receptor modulators in preventing voiding dysfunction in rats
Kavirach Tantiwongse (2008)
Relationship between dietary phytoestrogens and development of urinary incontinence in midlife women
L. E. Waetjen (2013)
Pelvic floor dysfunction--does menopause duration matter?
G. Trutnovsky (2013)
Oestrogen and progestin increased urge and stress incontinence in postmenopausal women with coronary heart disease
L. Robbs (2006)
Clinical Study: Effect of Supplementation with High Genistein Soybean Isoflavones and Pumpkin Standardized Extract on Urinary Incontinence in Western Perimenopausal Women
José Angel Marañón (2017)
Le traitement conservateur de l’incontinence urinaire d’effort de la femme
P. Denys (2010)
Urodynamics in women from menopause to oldest age: what motive? What diagnosis?
F. Valentini (2011)
Urinary Incontinence in Adults EAU Guidelines on
G. Lemack (2016)
Oestrogen therapy for urinary incontinence in post-menopausal women.
June D Cody (2012)
Menopause, hormone treatment and urinary incontinence at midlife.
G. Legendre (2013)
Urinary Incontinence in Women
C. Vaughan (2020)
Estrogen and urinary incontinence
K. Hirai (2009)
Specific features of therapy for disordered urination in menopausal women
P. Balan ()
NHG-standaard incontinentie voor urine
A. Lagro-Janssen (2009)
The use of hormone therapy for the maintenance of urogynecological and sexual health post WHI
R. Nappi (2012)
Female urinary incontinence : quality of life comparison on reproductive age and postmenopausal period
M. Rett (2016)
Recommandations pour le traitement médicamenteux de l’incontinence urinaire non neurologique féminine
S. Conquy (2010)
Guideline of guidelines: urinary incontinence
Raveen Syan (2016)
Vrais et faux bénéfices et risques des traitements hormonaux de la ménopause
C. Jamin (2007)
Le traitement hormonal de la ménopause : après sept ans de polémiques
C. Jamin (2009)
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