Postmenopausal hormones and incontinence: the heart and Estrogen/Progestin Replacement Study☆
Section snippets
Materials and methods
The design, methods, baseline patient characteristics,8 and main findings9 of the trial have been published. Briefly, participants were postmenopausal women less than 80 years old with established coronary heart disease who had not had a hysterectomy. Participants were randomly assigned to treatment with daily oral conjugated estrogen (0.625 mg) and medroxyprogesterone acetate (2.5 mg) in one tablet (Prempro; Wyeth-Ayerst Research, Radnor, PA) or identical placebo. The randomization codes were
Results
Between January 1993 and September 1994, the 20 centers enrolled 2763 women. At the beginning of the trial, 1525 participants reported urinary incontinence at least once per week. Of these 1525 participants, 768 were randomly assigned to receive hormone therapy and 757 were assigned to placebo.
There were no significant differences between the treatment groups at baseline in demographic or reproductive characteristics, reported medical conditions, or use of incontinence medications. At baseline,
Discussion
Among women assigned to treatment with hormone therapy, incontinence was more likely to worsen and less likely to improve than among women assigned to placebo. There was no improvement among hormone-treated women in the frequency of either stress or urge incontinence and no reduction in either diurnal or nocturnal urinary frequency.
The urethra and trigone of the bladder are covered by nonkeratinized squamous epithelium of similar origin to the vagina.12 These tissues contain estrogen receptors4
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Supported by Wyeth-Ayerst Research, Radnor, PA. Wyeth-Ayerst is a wholly owned subsidiary of American Home Products and manufactures Prempro, the medication used in this study.