Menopausal hormone therapy (MHT), consisting of oral estrogen plus progestin or estrogen alone, considered in the past as treatment for urinary incontinenc, was until recently, credited with many benefits well beyond the indications for symptomatic relief of hot flashes, night sweats, and vaginal dryness. One of the benefits of MHT was to improve the symptoms of urinary incontinence (UI), and it has often been prescribed to treat UI.
Susan L. Hendrix, D.O., of the Wayne State University School of Medicine and Hutzel Women's Hospital, Detroit, and colleagues conducted a study to determine the effects of MHT on the 1-year incidence and severity of symptoms of stress incontinence that occurs when involuntary pressure is put on the bladder by coughing, laughing, sneezing, lifting or straining; urge incontinence that is generally attributable to involuntary contracts of the bladder muscle, and mixed UI ,involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing in healthy postmenopausal women. Data analyzed from the Women's Health Initiative [WHI] multicenter double-blind, placebo-controlled, randomized clinical trials of menopausal hormone therapy in 27,347 postmenopausal women aged 50 to 79 years enrolled between 1993 and 1998. Existence of any UI symptoms was known for 23,296 participants at baseline and 1 year. Women were randomized to receive estrogen alone (conjugated equine estrogen, [CEE]), estrogen plus progestin (CEE plus medroxyprogesterone acetate [MPA]), or placebo.
The trials, designed to evaluate the effects of MHT using estrogen and progestin or estrogen alone in preventing coronary heart disease and hip fractures in postmenopausal women, ended prematurely because more harm than benefit was observed.