What type of urinary incontinence is vaginal estrogen most effective in treating?

Vaginal estrogen is particularly effective in treating stress urinary incontinence because this type of incontinence often arises due to weakened pelvic floor muscles and tissues that can occur during menopause, when estrogen levels decline. Estrogen plays a vital role in maintaining the integrity of the urogenital tissues. By localizing estrogen therapy to the vaginal area, it promotes the health of the urethra and surrounding structures, thereby improving muscle tone and support, which can reduce the frequency of involuntary leakage that is associated with stress incontinence activities, such as laughing, coughing, or exercise.

In contrast, other types of urinary incontinence, such as urge incontinence, are related to bladder muscle spasms and are typically not directly affected by vaginal estrogen. Mixed urinary incontinence can involve elements of both stress and urge incontinence, but the specific benefits of vaginal estrogen are more pronounced for stress components. Overflow incontinence relates to bladder overdistension and is also not effectively treated by estrogen, as it is more related to emptying issues than tissue integrity.