The information provided below is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.

Two types of urinary incontinence are treatable with medications:

  • Stress Incontinence —In postmenopausal women, pelvic floor relaxation is the most common cause of stress incontinence. This may improve with the use of estrogen
  • Urgency and Overflow Incontinence —These conditions, which result from a bladder muscle that is stronger than the sphincter muscle, may respond to anticholinergic medicines that weaken the bladder muscle. Alpha-adrenergic medicines that strengthen the sphincter may also be helpful.

Prescription Medications

Estrogens

  • Oral
  • Injectable
  • Topical
  • Transdermal

Anticholinergics

  • Darifenacin (Enablex)
  • Flavoxate (Urispas)
  • Oxybutynin (Ditropan)
  • Solifenacin (Vesicare)
  • Tolterodine (Detrol)
  • Trospium (Sanctura)

Estrogens

Common names include:

  • Oral
    • Conjugated estrogens (Premarin)
    • Estradiol (Estrace)
    • Esterified estrogens (Menest, Estratab)
    • Estropipate (Ogen)
    • Ethinyl Estradiol (Estinyl)
  • Injectable
    • Estrone (Kestrone)
    • Estradiol cypionate in oil (DepoGen, depGynogen)
  • Topical
    • Ogen
    • Premarin
    • Estrace
    • Estring
  • Transdermal
  • Estradiol (Estraderm, FemPatch, Vivelle, Alora, Climara)

Estrogen is the hormone that stimulates and maintains the breasts, ovaries, uterus, and vagina. At menopause , estrogen levels drop dramatically and these organs begin to age. The tissue that supports the bladder is the anterior wall of the vagina. If this becomes weakened and stretched out, the bladder drops, and stress incontinence may result. Replacing estrogen in your body rejuvenates the vaginal wall and may cure the leaking.

Estrogen has both positive and negative effects. Currently, controversy rages over the use of estrogen in postmenopausal women. To avoid most of the side effects, estrogen for urinary stress incontinence can be given topically as a vaginal cream with results equal to or superior to giving it by other routes.

Possible side effects include:

  • Stronger bones
  • Healthier female tissues
  • More rapid growth of other female cancers, such as the breast and uterine cancers
  • Gall bladder disease
  • Blood clots
  • High blood pressure

Anticholinergics

Common names include:

  • Darifenacin (Enablex)
  • Flavoxate (Urispas)
  • Oxybutynin (Ditropan)
  • Solifenacin (Vesicare)
  • Tolterodine (Detrol)
  • Trospium (Sanctura)

These drugs act on the autonomic (automatic) nervous system to alter the balance between bladder pressure and sphincter tone. They specifically weaken the bladder emptying muscle, relieving incontinence that is caused by a sudden urges to void due to full or irritated bladder.

Possible side effects include:

Special Considerations

When using estrogen other than the topical creams, ask your physician to discuss the pros and cons. Also, some medical problems may contraindicate the use of this medications. For example, estrogens are contraindicated in patients with breast and endometrial cancer. Patients with some types of glaucoma cannot use anticholinergics.

If you have bladder trouble, check with your physician before using any other medications, including over-the-counter drugs and herbal supplements. Many have urinary side effects.

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.

When to Contact Your Healthcare Provider

Contact your healthcare provider if:

  • You have concerns about estrogen treatment
  • Side effects are causing significant problems