Estrogen and urinary incontinence in women

Objective: The purpose of this study was to review the efficacy of estrogen therapy for urinary incontinence by examining published trials and to review the epidemiologic and physiologic evidence for its action. Data Sources: Controlled and uncontrolled trials of estrogen therapy in the English literature were collected. Eight controlled and 14 uncontrolled trials were identified. Methods of Study Selection: Trials were selected if they were prospective. All types of estrogen treatment were included. All types of outcome measurements were included. Data Extraction and Synthesis: Trials were categorized by type of estrogen used; outcome variables (subjective improvement vs. objective urodynamic data); and cure/improvement rates. Conclusions: Published trials do not support estrogen replacement as efficacious therapy for stress urinary incontinence. It may be useful for incontinence associated with urgency and frequency. Adequately large controlled trials that evaluate estrogen replacement regimens used in the USA remain to be done.