Medications

Urinary incontinence may be treated with medicines. But in many cases treatment with behavioral methods (for urge incontinence) and Kegel exercises (for stress incontinence) are tried before medicines.

Even when medication treatment helps with incontinence, there may be side effects or interactions with other medicines.

Medication Choices

For stress incontinence, medicine choices may include:

• Antidepressant medicine (duloxetine or imipramine). Duloxetine can help control stress incontinence. Studies show that duloxetine reduces the number of times women have stress incontinence.⁶ How it works is not known. Imipramine causes the bladder muscle to relax while also causing the muscles at the bladder neck to contract. There are no well-done studies of imipramine for incontinence. But it reportedly works for some women.

Treatment for urge incontinence may include:

• Anticholinergic medicines, such as Detrol, Ditropan, and Oxytrol. These often are effective for urge incontinence, but they have side effects that include dry mouth, constipation, blurred vision, and an inability to urinate. Time-release and skin-patch formulas may have fewer side effects.
• Imipramine (such as Tofranil), an antidepressant medicine that may be used to treat both urge and stress incontinence. It is often used in combination with an anticholinergic medicine.

What To Think About

Medicine is often used in combination with behavioral methods. For more information on behavioral methods, see the Other Treatment section in this topic.

Hormone therapy. Do not use hormone replacement therapy (HRT) to treat stress incontinence. One large study found that more women taking estrogen for a year had urinary incontinence problems than women who took no hormones.⁷ And other studies have found that estrogen has no effect on incontinence.⁸

Applying a small amount of estrogen cream just inside the vagina may help some menopausal women with urge incontinence.³ But this has not been well-studied.