A single site, double-blinded, randomized controlled trial for postmenopausal women with urinary frequency, urgency, nocturia with or without urgency urinary incontinence symptoms. Patient's will be randomized between 0.01% vaginal estradiol cream with placebo oral pill or daily 50 milligrams oral Mirabegron with a placebo vaginal cream for 12 weeks.
Raw score of 14 or more on OAB-q SF (adjusted score of 20)
Postmenopausal defined by not having a period for 12 months or bilateral oophorectomy a least 12 months status post procedure, or women with prior hysterectomy and preserved ovaries over age 55 years old or having a documented follicle stimulating hormone level greater than 40mIU/mL.
Ability to speak and read English
Contraindications to Vaginal Estrogen or Mirabegron
Post void residual >200mL or >1/3 patient's total bladder volume
Currently on or previously taking anticholinergic or beta- 3 agonists within the past 1 month
Symptomatic pelvic organ prolapse greater than Stage 2, contraindication to vaginal estrogen therapy