In climacteric women stress and urge incontinence often occur as a consequence of estrogen deficiency. Urinary incontinence is defined as involuntary discharge of urine associated with psychologic and hygienic problems. Of 3,248 women investigated between 1986 and 1990 at our Clinic for Climacteric Dysfunctions, Vienna, 1,039 women (32%) reported symptoms such as vaginal dryness, incontinence and problems with regard to cohabitation. Indications for estrogen replacement therapy in and/or after the climacteric period are urinary stress incontinence degree I, urge incontinence (pollakisuria, nycturia), atrophic urethritis as well as preoperative estrogen replacement. For therapeutic management both conjugated estrogens and estradiol as well as estriol preparations may be employed, taking the contraindications into account. Postmenopausal estrogen replacement is highly indicated with dysfunctions in the area of urethra and urinary bladder.
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