dermal estrogen: RR 1.68, 95% CI 1.41, 2.00; oral estrogen with progestin: RR 1.34, 95% CI 1.24, 1.44; transdermal estrogen with progestin: RR 1.46, 95% CI 1.16, 1.84). There was little risk after the cessation of hormones (RR 1.14, 95% CI 1.06, 1.23) and a decreasing risk of incontinence with increasing time since last hormone use; 10 years after stopping hormones, the risk was identical in women who had and had never taken hormone therapy (RR 1.02, 95% CI 0.91, 1.14). CONCLUSION: Postmenopausal hormone therapy appears to increase risk of developing urinary incontinence. This risk does not vary by route of administration, type of hormones, or dose taken, but is diminished upon cessation of use. Editorial Comment: This large study supports the randomized trials which have indicated that hormone therapy does not improve urinary symptoms. In fact,there was a significant increase in the risk of developing incontinence over 4 years in those taking postmenopausal hormone therapy at baseline,and this risk was similar for users of estrogen alone and estrogen combined with progestin,as well as users of oral or transdermal estrogen. The elevated risk was evident for short-term and long-term users but decreased after cessation of hormone therapy. Symptoms of stress and urge incontinence were not separated,however—a shortcoming of the study,as it is certainly possible that one type could be affected and not the other,and it is even possible that one type could be benefited. The authors acknowledge this in their discussion,and also the fact that (1) all information on hormone therapy and incontinence is self-reported,and (2) in an observational study it is possible that results are due to confounding but they point out that this potential is reduced because health professionals in this subject all had good access to health care and sound health knowledge regardless of their hormone use.