Oestrogen therapy for urinary incontinence in post-menopausal women

Cody, June D; Richardson, Karen; Moehrer, Birgit; Hextall, Andrew; Glazener, Cathryn

doi:10.1002/14651858.cd001405.pub3

Cited by 237 publications

(225 citation statements)

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“…Up to 70% of women relate the onset of urinary incontinence to their final menstrual period [6] . The 2012 Cochrane review regarding oestrogen therapy for urinary incontinence shows that topical oestrogen treatment may improve urinary incontinence [7] . Most of the available evidence regarding proven benefit deals with the symptom of UUI, showing improvement in urgency and bladder capacity [8] .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Vaginal Oestriol Cream on Subjective and Objective Symptoms of Stress Urinary Incontinence and Vaginal Atrophy: An International Multi-Centre Pilot Study

Weber

Lim

Oryszczyn

et al. 2016

Gynecol Obstet Invest

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Aim: Subjectively and objectively assess stress urinary incontinence (SUI) symptoms before and after topical oestrogen therapy. Methods: A prospective study was performed in 3 centres in South-Africa, Australia and the Netherlands. Postmenopausal women with SUI were treated with topical oestriol cream for 6 weeks. The primary subjective outcome was the Patient's Global Impression of Improvement (PGI-I) scale. The primary objective outcome was vaginal pH. Secondary subjective outcomes were: the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form, the Incontinence Impact Questionnaire, the Urogenital Distress Inventory (UDI-6) and the most bothersome symptom approach. Secondary objective outcome was the erect cough pad test. Compliance was scored. Results: A total of 68 women were enrolled. Half of the participants reported improvement on the PGI-I scale after treatment. Vaginal pH was significantly lower after treatment (median 5.3 (interquartile range (IQR) 4.5-6.0) vs. 5.0 (4.4-5.4), p = 0.002). Improvement on the UDI stress domain was observed (p = 0.01). No statistically significant differences were found in the other subjective outcomes. Baseline and repeat cough pad tests demonstrated a wide variation with no significant difference. Compliance was high (median 100 (IQR 83-100%)). Conclusion: Topical oestriol cream during 6 weeks improved quality of life and vaginal pH but no other objective measures of incontinence.

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Section: Introductionmentioning

confidence: 99%

The Effect of Vaginal Oestriol Cream on Subjective and Objective Symptoms of Stress Urinary Incontinence and Vaginal Atrophy: An International Multi-Centre Pilot Study

Weber

Lim

Oryszczyn

et al. 2016

Gynecol Obstet Invest

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“…Urinary frequency and urgency, urge incontinence and nocturia are all improved by local vaginal oestrogens as long as therapy is continued, again with no reported negative effects. 36 Alternatively, nonhormonal lubrication has been shown to be of benefit, especially for dyspareunia and irritation. 37 Nonhormonal vaginal moisturisers are now available on prescription, which can be used for general comfort, not just for lubrication during intercourse.…”

Section: Treatment Of Genitourinary Symptomsmentioning

confidence: 99%

The menopause: benefits and risks of available treatments

Cochrane¹,

Currie²

2017

Prescriber

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“…For older women intravaginal oestrogen therapy can provide some improvement in the symptoms of UI especially in post-menopausal women with vaginal atrophy (Panay et al, 2013, Cody et al, 2009and NICE, 2013a. Intravaginal oestrogen has an effect on the bladder and urethral epithelium and may help relieve symptoms of urinary frequency, urgency and possibly reduce recurrent urinary tract infections (Panay et al, 2013) Systemic oestrogen or hormone replacement therapy is contraindicated in the treatment of urinary incontinence due to the association with systemic side effects such as thromboembolism and stroke and may in fact increase the likelihood of developing urinary incontinence (Panay et al, 2013 andNICE, 2006).…”

Section: Oestrogensmentioning

confidence: 99%