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Menopause And Incontinence

Many women experience bladder leakage during perimenopause and menopause, but it doesn’t mean you have to live with it. Learn why it happens and what can be done to treat symptoms of urinary incontinence during this time.

We’ve all heard the hallmark symptoms of menopause – hot flashes, mood swings, and night sweats to name a few. But one very common symptom of menopause that many women don’t discuss is urinary incontinence.

Many women are surprised when they discover that it’s harder to control their bladder during perimenopause and menopause. And while this is a common symptom of menopause, that doesn’t make it normal.

WOMEN CAN EXPERIENCE MANY DIFFERENT TYPES OF INCONTINENCE AS THEIR BODY EXPERIENCES CHANGE:

  • Stress incontinence causes you to leak urine when you place increased pressure (stress) on your bladder. You might notice that you unexpectedly start leaking a little when you sneeze, cough, laugh or work out.
  • Urge incontinence, which is associated with overactive bladder, can make you feel like you have to pee right away, often feeling the urge to go many times a day, even after you just went. When you don’t make it to the bathroom in time, this can result in incontinence.
  • Many women experience an increase in the number of times they need to empty their bladder at night. Needing to use the bathroom 2 or more times per night is a condition known as nocturia.

WHY DO BLADDER LEAKS OCCUR DURING MENOPAUSE?

Every woman will go through menopause in her lifetime. It’s officially defined as the last menstrual period that a woman experiences. The years leading up to menopause are called perimenopause and may start years before you actually have your last period. (The average age for women to experience menopause in the US is 51.) It’s during this time that the body goes through many changes, most notably a dramatic decrease in the amount of estrogen that is produced by the ovaries.

Leading up to perimenopause, estrogen plays an important role in keeping the bladder and pelvic floor strong. This decrease in estrogen causes many of the menopausal symptoms you’ve heard about, but it also causes the vaginal tissues to become less elastic and thin and can weaken your pelvic floor muscles. Without intervention, your muscles also naturally weaken with age.

Your weakened pelvic floor makes it harder to control your bladder, especially when stress is placed upon it (as mentioned above).

WHILE INCONTINENCE CAN HAPPEN TO ANYONE, SOME WOMEN MAY BE MORE SUSCEPTIBLE TO LEAKS DURING THIS TIME DUE TO CERTAIN RISK FACTORS:

CHILDBIRTH

Having babies is wonderful, but it can do a number on your pelvic floor, especially if you experienced difficult labor or childbirth. Many women are unaware of the damage that has been done to their pelvic floor due to childbirth. But during menopause, the loss of estrogen can exacerbate a potentially already weakened pelvic floor, leading to a leaky bladder.

NEUROLOGICAL CONDITIONS

Certain conditions such as multiple sclerosis, diabetes, or Parkinson’s disease can cause nerve damage which can make it harder to control the bladder.

MEDICATIONS

Some medications can cause bladder leakage too. Talk with your doctor if you suspect your medication is causing you problems.

YOUR LIFESTYLE

Certain foods and drinks can contribute to urinary incontinence by irritating the bladder, making you need to empty it more often. Caffeine and alcohol should be avoided, and sugar, spicy foods, or acidic foods are known to cause bladder irritation as well. Everyone is different so what may be a problem for some may not affect others. Experiment with a bladder diary to learn if what you’re eating seems to be contributing to your incontinence.

FINDING HELP FOR URINARY INCONTINENCE

While incontinence is a common condition, it’s not one that should be considered normal. Society has made it seem like a natural part of a woman’s life to experience bladder leaks as she gets older, and certain stigmas around incontinence have long kept women from speaking up about urinary incontinence, let alone get treatment for it.

But it doesn’t have to be that way. There have been many advances in the treatment options for urinary incontinence, and you’re bound to find something that works for you.

If left untreated, urinary incontinence can get worse and can decrease your quality of life. It’s not uncommon for people with incontinence to have depression, anxiety, or shame surrounding their condition. People with incontinence have reported that it causes them to miss social events, interrupt their work-life, and limit their time with family and friends. No one should have to live with urinary incontinence.

HOW CAN I TALK TO MY DOCTOR ABOUT URINARY INCONTINENCE

It may feel daunting to talk to your doctor about something so personal, but urinary incontinence is a real medical condition and one that many, many women experience. Your doctor has likely had this same discussion with many women before you and should be supportive. (If your doctor does not seem to be taking your concerns seriously, consider finding a new one.)

Your doctor may want to perform some tests to determine the health of your bladder and pelvic floor. He or she will also ask you lots of questions about how and when you leak, which will help determine the type of incontinence you may have.

TREATMENT OPTIONS FOR URINARY INCONTINENCE DURING MENOPAUSE

Your doctor may recommend a number of different treatment options depending on the severity of your condition, and what type of incontinence you have.

  • Pelvic Floor Strengthening. If it appears that your pelvic floor has become weakened, they may start with pelvic floor strengthening, and you may be referred to a physical therapist who can help set up a plan to help you work your pelvic floor and supporting muscles to make them stronger. Your physical therapist may also recommend the use of an electrical stimulation device that can help “wake up” your pelvic floor muscles and teach you how to perform a kegel. (Want to learn more about how to have a healthy pelvic floor? Visit our Pelvic Floor Health Center and sign up for our 6 weeks guided program!)
  • Hormone therapy. Some women find hormone therapy to be beneficial, especially if they are experiencing other symptoms as a result of a loss of estrogen. An estrogen patch or a vaginal cream containing estrogen may help with symptoms of bladder leaks.
  • Medications. There are several medications on the market that treat urge incontinence or overactive bladder.
  • A Pessary. Many women find using a pessary, a small device used to help hold the bladder in place, to be very helpful, especially if they experience stress incontinence.
  • Surgery. If nothing else works, your doctor may recommend a surgical procedure. There are many surgical approaches to treat urinary incontinence, and they vary depending on the type of incontinence you have. It’s also important to talk to your doctor about what to expect – surgery doesn’t always treat all types of urinary incontinence, so you may still experience some if you suffer from both urge incontinence and stress urinary incontinence.

If you’ve found that bladder leaks have become a problem for you, whether you’re going through menopause or not, we urge you to learn more about your condition and the treatment options out there and then talk to your doctor to figure out a plan to manage it together.

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