HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grodstein, F. Articles by Curhan, G. C. Search for Related Content PubMed PubMed Citation Articles by Grodstein, F. Articles by Curhan, G. C. Related Collections Epidemiology/public health Menopause and HRT Urogynecology

Postmenopausal Hormone Therapy and Risk of Developing Urinary Incontinence

From the Channing Laboratory and Renal Division, Department of Medicine, and Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; and Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Address reprint requests to: Dr. Francine Grodstein, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115; e-mail: fran.grodstein{at}channing.harvard.edu.

OBJECTIVE: To better understand associations between post-menopausal hormone therapy and the development of urinary incontinence.

METHODS: Postmenopausal hormone use was assessed via biennial mailed questionnaires beginning in 1976 among Nurses’ Health Study participants. In 1996, 39,436 post-menopausal women aged 50–75 years reported no leaking of urine and were followed-up for 4 years to identify incident cases of incontinence. We used logistic regression to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) for the relation of postmenopausal hormone use from 1976 to 1996 to the development of incontinence from 1996 to 2000.

RESULTS: We identified 5,060 incident cases of occasional (leaking urine 1–3 times/month) and 2,495 cases of frequent incontinence (leaking at least weekly) for average yearly incidence rates of 3.2% and 1.6%, respectively. The risk of incontinence was elevated among women taking postmenopausal hormones compared with women who had never taken hormones (oral estrogen: RR 1.54, 95% CI 1.44, 1.65; transdermal estrogen: RR 1.68, 95% CI 1.41, 2.00; oral estrogen with progestin: RR 1.34, 95% CI 1.24, 1.44; transdermal estrogen with progestin: RR 1.46, 95% CI 1.16, 1.84). There was little risk after the cessation of hormones (RR 1.14, 95% CI 1.06, 1.23) and a decreasing risk of incontinence with increasing time since last hormone use; 10 years after stopping hormones, the risk was identical in women who had and had never taken hormone therapy (RR 1.02, 95% CI 0.91, 1.14).

CONCLUSION: Postmenopausal hormone therapy appears to increase risk of developing urinary incontinence. This risk does not vary by route of administration, type of hormones, or dose taken, but is diminished upon cessation of use.

LEVEL OF EVIDENCE: II-2

This article has been cited by other articles:

				L. E. Waetjen, W.-Y. Feng, J. Ye, W. O. Johnson, G. A. Greendale, C. M. Sampselle, B. Sternfield, S. D. Harlow, E. B. Gold, and for the Study of Women's Health Across the Nation Factors Associated With Worsening and Improving Urinary Incontinence Across the Menopausal Transition Obstet. Gynecol., March 1, 2008; 111(3): 667 - 677. [Abstract] [Full Text] [PDF]

				S. L. Jackson, D. Scholes, E. J. Boyko, L. Abraham, and S. D. Fihn Predictors of Urinary Incontinence in a Prospective Cohort of Postmenopausal Women. Obstet. Gynecol., October 1, 2006; 108(4): 855 - 862. [Abstract] [Full Text] [PDF]

				J. E. Steinauer, L. E. Waetjen, E. Vittinghoff, L. L. Subak, S. B. Hulley, D. Grady, F. Lin, J. S. Brown, and for the Heart and Estrogen/Progestin Replacement S Postmenopausal Hormone Therapy: Does It Cause Incontinence? Obstet. Gynecol., November 1, 2005; 106(5): 940 - 945. [Abstract] [Full Text] [PDF]

				L. E. Waetjen, J. S. Brown, E. Vittinghoff, K. E. Ensrud, J. Pinkerton, R. Wallace, J. L. Macer, D. Grady, and for the Ultra Low Dose Transdermal estRogen Assess The Effect of Ultralow-Dose Transdermal Estradiol on Urinary Incontinence in Postmenopausal Women Obstet. Gynecol., November 1, 2005; 106(5): 946 - 952. [Abstract] [Full Text] [PDF]

				S R Davis, I Dinatale, L Rivera-Woll, and S Davison Postmenopausal hormone therapy: from monkey glands to transdermal patches J. Endocrinol., May 1, 2005; 185(2): 207 - 222. [Abstract] [Full Text] [PDF]

				L.M. Helvering, M.D. Adrian, A.G. Geiser, S.T. Estrem, T. Wei, S. Huang, P. Chen, E.R. Dow, J. N. Calley, J.A. Dodge, et al. Differential Effects of Estrogen and Raloxifene on Messenger RNA and Matrix Metalloproteinase 2 Activity in the Rat Uterus Biol Reprod, April 1, 2005; 72(4): 830 - 841. [Abstract] [Full Text] [PDF]

				K. Tapp, A. Connolly, and A. G. Visco Evaluation of Aa Point and Cotton-Tipped Swab Test as Predictors of Urodynamic Stress Incontinence Obstet. Gynecol., January 1, 2005; 105(1): 115 - 119. [Abstract] [Full Text] [PDF]