Vaginal oestrogen protects against incontinence
16 October 2009
Application of local vaginal oestrogen (for example, vaginal creams or tablets) may improve or even cure urinary incontinence in women who have been through menopause, researchers say, although its benefits may not continue after treatment stops.
A Cochrane review of 33 trials found local oestrogen therapy improved incontinence by 26 per cent compared to placebo (dummy treatment).
Overall, there were one or 2 fewer voids in 24 hours and fewer nocturnal voids among women treated with local oestrogen, and urgency (a strong, uncontrollable urge to urinate) was also reduced.
Some users experienced vaginal spotting, breast tenderness or nausea, but no serious side effects were reported among users of local oestrogen.
However, the authors said there was little evidence on whether these improvements continued after treatment stopped.
They said the risk of breast cancer and cancer of the endometrium (lining of the uterus) after long-term use suggested that any oestrogen treatment should be used for limited periods.
The authors found that in 2 large trials where women received hormone replacement therapy, including oral oestrogen, incontinence was worsened by 32 per cent when compared to placebo. This effect was lessened when adjusted to include only women with an intact uterus.
“The risks of long-term treatment with oestrogens suggest that treatment should be for limited periods, and using local (vaginal) rather than systemic administration, if possible, especially in women with an intact uterus,” the authors said.
Last Reviewed: 16 October 2009
- 1. Cody JD, Richardson K, Moehrer B, Hextall A, Glazener CMA. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD001405. DOI: 10.1002/14651858.CD001405.pub2
