The Impact of Hormone Therapy on Urinary Incontinence

Have you been struggling to hold in your urine? You are not alone. According to a study published in the Journal of American Urogynecologic Society, over 60% of adult women in the US suffer from this embarrassing condition. It is known as urinary incontinence (UI) and is a common postmenopausal ailment. Some of its other risk factors include pregnancy and multiple vaginal births.  

One of the treatments you may be recommended for managing UI is hormonal therapy. In addition to treating urinary incontinence, this therapy relieves several other postmenopausal conditions, such as vaginal dryness, night sweats, and hot flashes.  

What Is Hormone Therapy? 

Hormone Replacement Therapy (HRT) is a form of treatment that involves the administration of hormones, particularly estrogen, progestin (a form of progesterone), or both. A woman’s body stops producing these hormones after menopause, leading to conditions such as urinary incontinence. Reintroducing the hormones in various forms, including pills, patches, creams, and vaginal rings, can help reverse the effects of these ailments. 

Estrogen and the Urinary System

Estrogen is a hormone produced naturally in women within the ovaries. Its functions include: 

  • Keeping the vagina healthy
  • Thickening the lining of the uterus in preparation for implantation
  • Maintaining healthy levels of cholesterol in the blood
  • Assisting in curbing osteoporosis 
  • Influencing the use of calcium in the body 

HRT for Postmenopausal Women

If you are past menopause, getting a hormonal therapy prescription can boost your estrogen levels. Research suggests that it can help lower UI symptoms since more estrogen in the body leads to stronger and more elastic urinary tract tissues. 

HRT for Prostate Cancer Patients

Prostate cancer comes about due to the stimulation of cancer cells by hormones known as androgens. Testosterone is one of the most known androgens. Hormone therapy assists in killing prostate cancer cells or stunting their growth.   

HRT in Gender Transitioning

Hormone therapy helps in aligning an individual’s body with their identity. The treatment is administered to transgender individuals through a process known as gender affirmation, which blocks male hormones while activating the female ones, or vice versa, depending on your preferred gender. 

How Hormone Replacement Therapy Impacts Urinary Incontinence   

The effect that HRT has on UI depends on the kind of treatment conducted. Below is how they vary. 

Menopausal Hormone Therapy (MHT)

There are two ways of administering this treatment: 

  1. Estrogen therapy. This form of treatment helps in thickening and strengthening the genitourinary tract. By strengthening these tissues, it can lower the symptoms of UI, including stress incontinence and urine leaks.
  2. Combined (estrogen and progestin) therapy. For this mode of treatment, the impact on UI can vary. While estrogen can help reduce the symptoms, progestin can, at times, counteract the benefits gained. 

Androgen Deprivation Therapy (ADT)

Whereas ADT effectively slows and controls cancer growth, it may have adverse side effects such as urinary incontinence. The treatment resulting in lower testosterone levels could weaken the pelvic floor muscles, leading to UI. As a result, interventions such as pelvic exercises may be necessary in managing UI if you are getting ADT. 

Gender-Affirming Hormone Therapy (GAHT) 

The impact of GAHT on urinary incontinence largely depends on the type of hormones used in your procedure. For transgender women (assigned male at birth), the process results in reduced testosterone and thus could lead to relaxed pelvic floor muscles. As a result, you may experience urge incontinence, stress incontinence, and other forms of UI. 

For transgender men (assigned female at birth), the process results in decreased estrogen levels. It may lead to an overactive bladder and problems emptying the bladder

Hormone Therapy Risks and Considerations

While this therapy is beneficial to many women undergoing menopause and those experiencing urinary incontinence due to other reasons, it is also risky. The significant side effects associated with it include: 

  • Mood swings
  • Headaches
  • Breast soreness
  • Bloating
  • Irregular bleeding
  • Water retention
  • Nausea 

The treatment is also known to increase the chances of the following: 

  • Blood clots and stroke
  • Endometrial cancer (only in those who still have their uterus intact and are not taking progestin alongside estrogen)
  • Breast cancer upon long-term use
  • Dementia if one starts the treatment after midlife
  • Gallstone/ gallbladder issues  

If you are considering hormone therapy, reviewing the potential risks and benefits individually with your healthcare provider is essential. 

Alternative Treatments and Management

A number of substitute treatments exist for hormonal therapy, including: 

  • Alternative medicine, such as homeopathy, acupuncture, and acupressure 
  • Bladder training
  • Herbal medicine
  • Complementary therapy, where several interventions are used alongside traditional medicine
  • Non-hormonal prescriptions, such as antidepressants
  • Exercises and lifestyle changes that can help to manage symptoms

Urinary Incontinence Treatment in Middle Tennessee

Urinary incontinence is a prevalent condition affecting many individuals, particularly postmenopausal women. Hormone replacement therapy can help alleviate this affliction, mainly through estrogen supplementation to help revive the vigor of your reproductive tract. However, this therapy has several risks, and you should only do it after consulting with your doctor to know what is best for your unique case. If you have additional questions about the impact of hormone therapy on UI or about UI in general, contact our team to speak to a medical concierge.

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.

Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

Contact Us

Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067