Menopause incontinence, (bladder control problems) is experienced by many women leading up to menopause and beyond. It can also be a symptom of aging or related to other health conditions. In menopause, the occurrence or not, extent and severity varies from woman to woman.
Urinary incontinence also known as loss of bladder control or urinary leakage refers to a situation where involuntary loss of urine takes place.
With lifestyle changes, bladder retraining and/or medical treatment, menopause incontinence can be resolved.
How The Bladder Works
• The urine produced by the kidneys is held in a sac called the bladder
• When the bladder is full the urine needs to be expelled through the urethra – this takes place with urination
• The pelvic muscles and the sphincter are trained to keep your body from expelling urine
What Happens To The Bladder In Menopause
• During menopause your estrogen levels decline
• Estrogen is responsible for keeping the bladder lining healthy
• Estrogen is responsible for keeping the urethra healthy
• Estrogen stimulates the blood flow in the pelvic region and this increases the strength of the pelvic muscles
• Due to reduced estrogen the pelvic muscles become weaker and these muscles may not be strong enough to hold the bladder closed
• Result – unwanted leakage of urine
Types Of Urinary Incontinence
This is where leakage of urine occurs due to unexpected pressure on the abdomen that pushes down on the bladder. Laughing, coughing, sneezing, lifting something or exercising can all cause leakage. Stress incontinence is the most common type of incontinence experienced by menopausal and postmenopausal women.
Sometimes referred to as overactive bladder. This is where you frequently feel the urge to go to the bathroom. This type of incontinence is most commonly experienced in elderly people.
A combination of both stress and urge incontinence.
This occurs when the bladder doesn’t completely empty and fills again very quickly resulting in frequent trips to the bathroom. Most common in people who have damaged bladders or blocked urethras. It can also be as a result of nerve damaged caused by diabetes. Urine leakage is quite common in this case.
Lifestyle Changes Which May Help Menopause Incontinence
- Limit your intake of caffeine to stop excess urination. Alcohol and smoking can also contribute to bladder problems
- Eat a balanced diet rich in fruit and vegetables and whole grains – this will help to reduce the problem
- Drink around 6-8 glass of water each day – this will help to flush out bacteria that accumulates in the bladder
- Kegel Exercises – will help to strengthen the pelvic muscles. In these exercises the muscles around the urethra, vagina and anus are gently contracted. After holding on to this contraction for a few seconds the muscles should be relaxed. If you need help with these exercises consult with your Healthcare Professional. In June 2015, PeriCoach was launched, a home personal trainer device and app to help manage and monitor your pelvic floor exercises. You can read more about this device here, where you will also find GP and Presenter for the UK’s Channel 4 series, Embarrassing Bodies, Dr Pixie McKenna’s advice and tips on how to strengthen your pelvic floor muscles
- If you are overweight, losing weight will take pressure of the bladder and help to improve control
- Menopause incontinence can lead to women avoiding intercourse. The simple practice of urinating immediately before intercourse may be helpful
Drink water and delay urination for around 5 minutes, slowly increasing this time to around 15 minutes. This will allow the bladder to hold a greater amount of urine and the need to urinate will decrease.
Medical and Surgical Treatments
In order to diagnose a bladder control problem, your Healthcare Professional will take a full medical history and perform a pelvic examination. Your urine will also be tested for signs of infection or other health related problems.
Cones and balls can be used and inserted to train the pelvic muscles to contract correctly.
Pessaries can be used to hold the pelvis up and off the bladder.
Bladder swings can be surgically implanted into the pelvic region helping
to support the bladder. Used in the case of continued incontinence.
Electrical Stimulation (Biofeedback). Electrical pulses are sent to the pelvic region to train the muscles to contract and to promote new nerve growth.
Botox can be injected into the bladder muscle causing it to relax.
Natural menopause relief products may help to readdress your hormonal imbalance.
Other Causes of Bladder Control Problems in Women
• Nerve damage caused by stroke or diabetes
• Previous pregnancies
• Difficulty with mobility
• Medications such as diuretics (water tablet), tranquillisers
• Weight gain
Hutchinson, S. M.D. (Nov 2007) The Stages of a Woman’s Life: Menstruation, Pregnancy, Nursing, Perimenopause, Menopause.
Urinary Incontinence. Retrieved from http://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/urinary-incontinence
Waetjen, L. E. (June 2011) Association between Menopausal Transition Stages and Developing Urinary Incontinence. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120214/
Urinary incontinence: The management of urinary incontinence in women. NICE Clinical Guideline. (Sep 2013) Retrieved from http://www.nice.org.uk/guidance/CG171/chapter/introduction
Wing, R. R., Creasman, J. M et al. (Aug 2010) Improving urinary incontinence in overweight and obese women through modest weight loss. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20664387?dopt=Abstract