Clinical Research Directory

Inclusion Criteria: * Women, age 60 years and older. * Medically documented pure stress urinary incontinence on physical exam or urodynamic testing. * Normal mammogram within the last 12 months * Endometrial thickness of ≤4 mm in women with an intact uterus assessed by endometrial ultrasound. * Ability and willingness to provide informed consent. Exclusion Criteria: * • Medically documented urge or mixed urinary incontinence (stress and urge) on physical exam or urodynamic testing. * Participating in pelvic floor muscle training (PFMT) therapy currently or in the past 3 months * Previous pelvic surgery (i.e., hysterectomy, pelvic organ prolapse repair, mid-urethral sling placement, injection of urethral bulking agents) or radiation treatment to the pelvis. * History of ≥ Grade 3 pelvic organ prolapse * Neurologic disorder causing UI or bladder dysfunction (i.e., multiple sclerosis, Parkinson's disease, stroke, cerebral palsy, spinal cord injury) * Current urinary tract infection * History of breast or endometrial cancer * Use of systemic estrogen therapy in the past 3 months * Baseline hematocrit \>48%, serum creatinine \>2.5 mg/dL; HbA1c \>8.0%; BMI \>40 kg/m2 * Uncontrolled hypertension defined as an average of two blood pressure readings of greater than 160/100. * Subjects who are on insulin therapy will be excluded. * Uncontrolled congestive heart failure * Myocardial infarction, acute coronary syndrome, revascularization surgery or stroke within 6 months * History of pulmonary embolism, deep vein thrombosis or a genetic thromboembolic disorder * History of bipolar disorder, schizophrenia or untreated major depression * Presence of metallic implants (pacemakers, aneurysm clips, etc.) that preclude the patient from undergoing MRI