For
several decades, doctors have been prescribing estrogen
to older women with urinary incontinence. But new findings
show that hormones worsen the symptoms. What's more, they
increase the risk of healthy women becoming incontinent.
This
is the latest bad news from the Women's Health Initiative
(WHI), the large clinical trial that had randomly assigned
over 27,000 healthy postmenopausal women, aged 50 to 79
years, to take either hormones or placebos. The trial
received enormous international media attention in 2002
when it had to be stopped prematurely due to a higher
incidence of serious conditions among the women taking
hormones. Among them were: more cases of breast cancer,
heart disease, stroke, blood clots, and dementia. These
harms greatly outweighed the two benefits—a reduced risk
of colon cancer and fractures—shown among the women on
hormones.
Researchers
continue to comb through the “goldmine” of data produced
by this trial. Gynecologist Susan L. Hendrix, DO, Wayne
State University School of Medicine, Detroit , and colleagues
looked at the incidence of incontinence in WHI participants
after one year of taking hormones or placebos. They found
an increase in all forms of urinary incontinence among
the women who took hormones, compared with those on placebos.
The
risk was highest for the most common form called stress
incontinence, which is characterized by leaking of urine
when coughing, sneezing, laughing, and/or exercising.
Women on hormone therapy were also more likely to report
that urinary incontinence had limited their daily activities.
The WHI is the first randomized trial to show that women
on estrogen alone were more likely to be incontinent than
women who did not take hormones. Until the WHI, the incontinence
risk was thought to be confined to women taking combination
hormones.
This
study was published in the February 23, 2005 issue of
JAMA, the Journal of the American Medical Association.
The WHI was a government-funded study so an extensive
account of the results is available at www.whi.org
Maryann
Napoli, Center for Medical Consumers © March 2005
