Apr
01
2005

Hormone Replacement Worsens Incontinence

By | Hormones, Prevention, Women’s Diseases

Once hailed as the miracle pill for the aging woman, hormone replacement therapy (HRT) is now being approached with caution. The infamous Women’s Health Initiative study, which first disproved benefits of hormone therapy, first pointed out an increase of breast cancer risk and risk of cardiovascular disease. On re-analysis of the data the Journal of the American Medical Association has published a study in its issue of February 23, 2005, which shows some more reason for caution with HRT. The previous notion that hormone replacement would improve the symptoms of urinary incontinence has turned out to be a fallacy. Dr. Susan Hendrix and her colleagues from Wayne State Untiversity School of Michigan in Detroit analyzed the data from 23,296 women with urinary incontinence. In randomized trials they received either estrogen alone, estrogen with progestin (Prempro) or the placebo effect (“fake pills”). Among those who were continent at the baseline, both, estrogens alone as well as the combination therapy were associated with an increased risk of incontinence at one year. Estrogen (Premarine) alone produced the most marked effect: stress incontinence increased by a factor of 2.15, the combination therapy increase stress incontinence by a factor of 1.87. In addition, women who were already suffering of incontinence, tended to report a worsening of their symptoms after beginning hormone therapy. The Women’s Health Initiative trials were stopped because the treatment risks appeared to outweigh its benefits. These new findings tilt the scales even further against hormone therapy, the authors say in their study.

Hormone Replacement Worsens Incontinence

Hormone Replacement Worsens Incontinence

Reference: National Review of Medicine, Canada, March 15, 2005, page 28

Comments on Nov. 8, 2012: We have to keep these observations in perspective. The authors of that study were using the “regular” Big Pharma manufactured hormone substitutes that the body cannot read. There are no Premarin or Provera receptors in the tissue, only testosterone receptors, estrogen receptors and progesterone receptors. These artificial hormones cannot be metabolized in the woman’s body into testosterone as bio-identical estrogen and progesterone would, because they are structurally different from the bio-identical hormones. The sad truth is that an anti-aging physician could have treated these poor women with incontinence safely by prescribing small amounts of testosterone cream that would have had to be applied to the urethral opening. From there the body would have sent it to the bladder, the bladder sphincter and the testosterone receptors that control these tissues and would have taken care of the incontinence problem.  You do not need a clinical trial. This type of treatment has been used in Europe for decades and has been used in the US for maybe 10 to 15 years as well by some open minded urologists and anti-aging physicians. The heading for this post is only applicable for HRT in the conventional sense (using Big Pharma drugs), but none of this applies to bio-identical hormone replacement for menopause.

More info on bio-identical hormone replacement in menopause: http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/menopause/

Last edited October 28, 2014

Nov
01
2002

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

By | Health, Heart Disease, Hormones, Prevention, Women’s Diseases

Dr. David D. Waters of the University of California at San Francisco reported in Chicago at the American Heart Association’s Scientific Session 2002 about the WAVE trial. This stands for “Women’s Angiographic Vitamin and Estrogen” trial.

The results of this study were simultaneously published in the Journal of the American Medical Association(JAMA 2002;288:2432-2440). It was a “carefully designed randomized study” where 423 women with established blood vessel damage to their hearts (established by angiography) were put on a therapy and then followed for an average of 2.8 years. Essentially the question was whether or not estrogen (Premarine) and vitamins (Vit.E and C) would have a protective effect on the blood vessels. Surprisingly the worst outcome was in the group with estrogen replacement and vitamins. The placebo group (=no estrogen, only vitamins) had the lowest death rate. The authors felt that the beneficial effect of estrogen (speak “Premarine”) on heart vessels could not been verified in this study. The take home message to the physicians at the conference was that they should concentrate on lowering the known risk factors: weight reduction, blood pressure control, cholesterol lowering and increasing exercise. Estrogen should be given in low doses (Premarine 0.625mg per day) only to those women who are symptomatic with hot flashes, but not to every postmenopausal woman.

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

NOTE : This group of postmenopausal women is a selection of women more likely suffering from hyperinsulinism with a higher rate of cardiovascular disease (and also arthritis and possibly a higher risk for cancer as well). The most logical therapy for these women is to work on weight loss, to increase exercise and to change their diet to a zone diet as this is known to lower cholesterol. Hoping to cure these women with estrogen or vitamin manipulation alone does not make “medical common sense” to me. Also, those women who had not had a hysterectomy were not dealt with as a separate group, although they were put on medroxyprogesterone acetate (Prempro). This is called a “confounding bias” and should have been openly discussed, which it was not. This means the WAVE trial made waves, but it was not a properly designed randomized study.

You may want to read these useful related links to chapters of my free Internet based Nethealthbook: For links to arteriosclerosis, heart attacks and strokes see this link: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/
For a link to hyperinsulinism follow this link:
http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 25, 2014