HRT linked to bladder-control problems
NEW YORK (Reuters Health) – Within a few months of starting
estrogen plus progestin hormone replacement therapy (HRT),
there is an elevated risk of urge and stress incontinence in
postmenopausal women, according to a new study.
Women considering HRT should be informed of the increased
risks of urge and stress urinary incontinence, the authors of
the study conclude in the November issue of the journal
Obstetrics & Gynecology.
More than 40 percent of postmenopausal women suffer from
urinary incontinence. In stress incontinence, the bladder tends
to leak urine when movement puts pressure on it — during
exercise, for example, or when a person laughs or coughs. Urge
incontinence is marked by an overwhelming and frequent urge to
Using data from the HERS study, which stands for Heart
Estrogen/progestin Replacement Study, Dr. Jody Steinauer, from
the University of California at San Francisco, and colleagues
assessed the occurrence of urinary incontinence in roughly
1,200 women who reported no episodes of incontinence in the
week prior to starting HRT or placebo. The subjects were
followed for about 4 years.
During this time, 64 percent of HRT-treated women reported
weekly incontinence compared with 49 percent of those given
placebo — a statistically significant difference. This
difference was noted at 4 months and persisted for the full
study period, independent of age.
Treatment with HRT increased the risk of urge and stress
incontinence by 50 percent and 70 percent, respectively. The
excess risks of weekly urge and stress incontinence attributed
to HRT were 12 percent and 16 percent, respectively.
The current study supports findings from previous
randomized trials suggesting that HRT can either trigger or
worsen urinary incontinence in postmenopausal women.
Interestingly, these results contradict physiologic data
suggesting that HRT might actually improve incontinence, the
SOURCE: Obstetrics and Gynecology November 2005.