As women age, they experience a gradual loss of estrogen. The rate of loss increases as menopause approaches. Low estrogen levels are associated with a number of symptoms, one of which is urinary incontinence. This happens because estrogen helps maintain connective tissue and muscle tone in areas that have many estrogen receptors, such as the vagina, urethra, and bladder.
Given that estrogen plays such a significant role in the function of these tissues, it makes sense that replacing the estrogen might be a good idea. For years, millions of women took synthetic estrogen to manage the symptoms of menopause, but in 2002 the Women’s Health Initiative study data showed that estrogen replacement might be causing more harm than good. In that study, oral estrogen replacement, in combination with medroxyprogesterone (a derivative of progestin), was associated with increased risk of cancer, stroke, and blood clots.
The majority of studies of oral estrogen for treatment of incontinence have shown that it actually makes symptoms worse in women who already have incontinence and can trigger incontinence in women who don’t already have it. Therefore, oral estrogen is not recommended as an option for treatment of incontinence.
However, there is some data that suggests that using topical estrogen may be of benefit. Direct application of the cream to the walls of the vagina and urethral tissue has been shown to increase tissue integrity and strength, often reducing the symptoms of incontinence and vaginal dryness that are common in menopause. Since the estrogen is not absorbed into the body in significant amounts, the risk of side effects is low.
Topical estrogen may be most effective when used in combination with other therapies, such as pelvic floor muscle training, also known as Kegel exercises. You’ll need a prescription for estrogen cream, so discuss the options with your doctor and be aware that side effects may occur, including breast tenderness, vaginal bleeding, headache, nausea, and bloating. Typically, you need four to 12 weeks of treatment before you notice improvements, and symptoms usually return about four to six weeks after therapy ends. Treatment plans will vary according to patient needs; follow your physician’s orders and continue with 3-6 month checkups with your prescribing doctor.
Do you have any experience with estrogen replacement therapy, or have you experienced incontinence issues during menopause? To connect with other women just like you, visit our incontinence forum. We’d love to hear your experiences, questions, and suggestions.
Additionally, you can find varying levels of products for incontinence at TotalHomeCareSupplies.com.