Progestogen HRT : it increases the risk of urinary incontinence . early as four months of treatment

Hormone replacement therapy (HRT) involving conjugated estrogens and medroxyprogesterone increases the risk of urinary incontinence at four months throughout the treatment, according to an analysis of the HERS study published in the journal " Obstetrics & Gynecology "

Several randomized trials have shown that postmenopausal women without incontinence , HRT increased the risk of urinary incontinence , especially in testing Nurses Health Study ( NHS) and the Women 's Health Initiative (WHI ) .

Jody E. Steinauer of the University of California at San Francisco and colleagues evaluated the risk in the study Heart Estrogen / progestin Replacement Study ( HERS ), another large study that assessed in a randomized placebo against HRT for the prevention of cardiovascular events in women who already have heart disease.

The analysis included 1208 participants who reported no episodes of urinary incontinence in the seven days before the start of the study.

During 4.2 years of follow-up , 64% of women assigned to HRT reported an episode of incontinence in the week before a visit, against 49% of women assigned to placebo.

The excess risk of incontinence in the treated group was evident four months of treatment, persisted throughout the treatment and was independent of the age of the patient.

Women on HRT had a 50% increased risk of urge incontinence and increased by 70% incontinence .

The authors calculated that the treatment of eight women for four years was associated with an additional case of weekly episodes of incontinence and treatment of six women was associated with an additional case of weekly incontinence episode in effort.

"Our results are based on treatment with conjugated equine estrogens at a standard dose combined with medroxyprogesterone acetate , and are can not be generalized to other hormonal systems ," the authors warn .

However, the results found in the NHS and WHI studies show the same problem with transdermal estrogen , oral estrogen alone and estrogen combined with progestin , they note.

Another study shows that treatment for two years with very low- dose transdermal estradiol alone did not alter the risk of incontinence.

The ULTRA , randomized, double-blind against placebo was evaluated in 417 postmenopausal women aged 60 to 80 years transdermal estradiol 0.014 mg / day in the prevention of osteoporosis.

The frequency of incontinence episodes was assessed at baseline and at four months and two years.

The prevalence of incontinence at least weekly was similar in both groups at baseline (43% ) indicate Dr. L. Elaine Waetjen of the University of California at Davis and his colleagues , some of whom have achieved in the previous analysis of the HERS study.

After two years , there was no difference between the two groups regarding the proportion of women with incontinence has improved, worsened or has not been changed.

In women without incontinence initially the risk of developing at least weekly incontinence was not significantly different in the two groups.