From the Research
Duloxetine is the primary prescription medication for stress urinary incontinence in females, typically prescribed at 40-80 mg daily. It works by increasing urethral sphincter tone through inhibition of serotonin and norepinephrine reuptake, which strengthens the urethral closure mechanism during physical activities that increase abdominal pressure 1, 2, 3, 4, 5. While using duloxetine, patients should continue pelvic floor exercises for optimal results. Common side effects include nausea, dry mouth, fatigue, and insomnia, which often improve with continued use.
Some key points to consider when prescribing duloxetine for stress urinary incontinence include:
- The medication can reduce incontinence episodes by 50-60% 3
- It is not FDA-approved specifically for stress incontinence in the US, though it is approved for this use in some European countries 1, 2
- Other medications sometimes used include topical estrogen for postmenopausal women with vaginal atrophy, which can improve urethral tissue integrity
- Treatment should be individualized, and patients should discuss potential drug interactions and contraindications with their healthcare provider before starting therapy 5
It's also important to note that duloxetine has been shown to be effective in women with severe stress urinary incontinence, and some women responding to duloxetine may reconsider their willingness to undergo surgery 3. Overall, duloxetine is a valuable treatment option for women with stress urinary incontinence, and its use should be considered in conjunction with other treatments, such as pelvic floor exercises and lifestyle modifications.