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23 February 2005
Hormone Therapy Worsens Urinary Incontinence 
Hormone therapy, either estrogen alone or used with progestin, was considered a treatment for urinary incontinence but has instead been found to increase the incidence of incontinence in postmenopausal women, says a study in the Journal of the American Medical Association. Menopausal hormone therapy has been used for some time to treat postmenopausal women for symptomatic relief of hot flashes, night sweats, and vaginal dryness. One of the purported benefits of menopausal hormone therapy was to improve the symptoms of urinary incontinence, and it has frequently been prescribed to treat this condition. The study, by Susan L. Hendrix of the Wayne State University School of Medicine and colleagues, sought to determine the effects of menopausal hormone therapy on the incidence and severity of incontinence symptoms in healthy postmenopausal women. She examined three types of incontinence. - Stress (involuntary pressure is put on the bladder by coughing or laughing or sneezing or lifting or straining),
- Urge (involuntary contractions of the bladder muscle) and
- Mixed urinary incontinence (involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing)
Hendrix and her co-researchers found that menopausal hormone therapy increased the incidence of all types of urinary incontinence among women who were continent. The risk was highest for stress incontinence, followed by mixed incontinence. Women receiving menopausal hormone therapy were more likely to report that urinary incontinence limited their daily activities and bothered or disturbed them. "Menopausal hormone therapy use does not confer protection against any type of urinary incontinence. On the contrary, the risk of new onset urinary incontinence among continent women was increased and urinary incontinence among symptomatic women was worsened," said the researchers.
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