Hormone Replacement Therapy (HRT), also called Estrogen Replacement Therapy (ERT), is most commonly given to women during or after menopause. HRT is used to help alleviate the symptoms of menopause. These replacement hormones are usually in pill, patch, gel, or pellet forms and work on the whole body. As far as using HRT for urinary incontinence symptoms, there is evidence from a meta-review from a 2012 report from the U.S. Preventative Services Task Force* that says using estrogen or estrogen plus progestin (the kind that acts on the whole body) actually increased cases of urinary incontinence.
HRT and ERT used alone are not effective to treat incontinence. They should also not be used solely to try and prevent incontinence symptoms.
Vaginal Estrogen Products
On the other hand, a recent 2014 meta-review** concluded that the use of US commercially available vaginal estrogen creams that are used to relieve the common vulvovaginal atrophy-related complaints that women experience in menopause, also helps patients partially relieve symptoms of:
- urinary urgency
- frequency or nocturia
- stress urinary incontinence
- urge urinary incontinence
- recurrent urinary tract infections
What does this all mean for a woman who has gone through menopause, has urinary incontinence, and is dealing with the normal changes that happen when estrogen levels fall in her body? It means you have to discuss your menopausal symptoms and urinary incontinence with your healthcare provider.
Many things need to be taken into consideration prior to treatment with a vaginal estrogen product (vaginal cream, vaginal tablet or a vaginal ring). And then the therapy needs to be monitored by your healthcare provider.
Each of us is unique. Our bodies react differently to medications and we all have different risk factors to consider. This will need to be a personal decision you make with your healthcare provider.
*Moyer VA; U.S. Preventive Services Task Force. Menopausal hormone therapy for the primary prevention of chronic conditions: U.S. Preventive Services Task Force recommendation statement. ANN INTERNAL MED, Jan 2013; 158(1):47-54.
**Rahn, David D., et al. Vaginal estrogen for genitourinary syndrome of menopause; a systematic review. OBSTETRICS & GYNECOLOGY, Dec 2014; 124(6):1147-1156.
Medical Reviewer: Shanna Atnip, MSN, WHNP-BC
Ms. Atnip is a Women’s Health Nurse Practitioner in the Urogynecology Division at Parkland Hospital in Dallas, Texas. At Parkland, the Urogynecology Division handles the full gamut of pelvic floor issues. Ms. Atnip has been a part of this department for sixteen years. She is a member of the Society of Urologic Nurses and Associates (SUNA) and the American Urogynecologic Society (AUGS). She has been the Southeast Regional Director of SUNA since 2011 and has served in many leadership roles within SUNA. She has also been a local and national speaker for SUNA conferences and symposia.