22 février, 2005 05:42
Tuesday, February 22 5:35pm By Jill Garrett
JAMA: Hormone Therapy Linked to Incontinence
By some estimates, up to half of all women over age 50 will suffer from urinary incontinence. Many women take hormone replacement therapy because doctors believe it can reduce the risk of urinary leakage.
A new study finds, just the opposite is true.
When Suretta Must started menopausal hot flashes, her doctor suggested hormone therapy. "I decided not to take hormones because of the larger risk of breast cancer and the fear of weight gain."
Now a new study shows there may be one more reason to reconsider hormone therapy -estrogen plus progestin or estrogen alone. The study in JAMA, the Journal of the American Medical Association, looks at the effect of these hormones on urinary incontinence.
"Urinary incontinence is a loss of urine that is sudden, spontaneous, without notice, and it affects women in their quality of life," Dr. Susan Hendrix says. She is an investigator with the Women's Health Initiative at Wayne State University .
The huge national study examining the many health effects of hormone therapy. She and her colleagues tracked the health of about 27,000 post-menopausal women for one year to see if hormones reduced incontinence.
"I was surprised because I thought estrogen therapy might help urinary incontinence, and we use estrogen to treat women with incontinence, and here we were prescribing a medication that not only didn't treat women but worsened their problem," she says.
In fact, the study showed that women who hadn't had leakage before taking the hormones were more likely to become incontinent. And women who were already incontinent were more likely to see their condition get worse.
"The risk increased anywhere from about 50 percent to over double the risk for leaking or worsening of leakage," an older patient says.
So what should women taking hormones do?
"They should realize that if they do have urinary leakage that they should talk to their doctor about trying to stop hormone therapy to see if they improve," Suretta says urinary leakage is one more reason she'll stay off hormones. "I mean you are left in a real embarrassing situation."
Doctor Hendrix says that previous research hinted that estrogen plus progestin might worsen incontinence, but this is the first study to confirm that estrogen alone, without progestin, also increases the risk.
