There are several uses for estrogens in treatment of incontinence and vaginal wall prolapse.
Both oral and vaginal estrogens can be utilized with success. There are estrogen receptors in the bladder and urethra. Presence of estrogens on these receptors either increases the density of alpha and beta-adrenergic receptors in the bladder and urethra. In turn, stimulation of these adrenergic receptors facilitates storage of urine thereby decreasing leakage and overactivity of the bladder. Additionally, the estrogen improves tissue integrity of the vagina and urethra. Often estrogen is given vaginally prior to prolapse surgery to improve healing. The debate about use and safety of estrogens is beyond the scope of this website. However, even with concern about use of oral estrogens, vaginal estrogen preparations are felt to be safe in low doses.