A study of the clinical effect of hormone replacement therapy for patients with stress incontinence

BACKGROUND: Our purpose was to clarify the effect of hormone replacement therapy (H.R.T.) for patients with stress incontinence. METHODS: We investigated 25 postmenopausal women, age 54-73 years, with a leakage volume is less than 15 g/day. In this study 0.625 mg of conjugated estrogen and 2.5 mg of medroxyprogesterone acetate were administrated for a total of 4 months. A clinical evaluation, measurement of volume of leakage per day and urodynamic evaluation (urethral pressure profile) were performed three times at pre administration, and at 2 months and 4 months after administration. RESULTS: Five of the 24 patients (20.8%) were improved significantly both clinically and urodynamically. Six patients (25.0%) improved clinically, and two patients (8.3%) improved urodynamically, the remaining 11 patients (45.8%) showed no change. Side effects occurred in eight cases. In one patient, it was necessary to stop administration due to severe irregular genital bleeding and leukorrhea, and in one patient the dosage was reduced due to swelling of breasts. The side effects of swelling of breasts and genital bleeding were relatively mild in the remaining six patients and they could continue H.R.T. administration. CONCLUSIONS: These results suggest that H.R.T. for patients with stress incontinence is not necessarily superior to the other non surgical methods. However, it may provide an alternative treatment method for incontinence.