What Is Female Urinary Incontinence
Involuntary leakage of urine, frequent urination, and a sudden urge to go to the bathroom, are all forms of urinary incontinence, which is generally defined as a lack of bladder control. While there are many causes, the most common cause is a gradual weakening of the pelvic floor muscles, nerves and tissue integrity that are meant to work together to control urination.
This is often caused by the stretching and atrophy of pelvic muscles due to age, pregnancy, gravity or trauma. Muscles can lose their elasticity as a result of pregnancies or carrying extra weight, and tissue membranes and sphincters can become less efficient with a loss of estrogen at menopause. Organs such as the uterus are then able to move around too freely, often pressing on the bladder itself. In some cases, the bladder or urethra may become damaged or chronically inflamed, and malfunction. Scarring from surgery, injury or infection may disrupt the natural alignment of the organs inside the pelvic area.
Why Does Menopause Make Your Bladder Weaker
Your ovaries stop making estrogen during this time in your life. That hormone is essential to women as it kicks in for puberty, as it controls your menstrual cycle, and during pregnancy. When its gone, your body gets to have a break from working so hard at all these stages.
- Your vaginal tissue becomes less elastic.
- The lining of your urethra, the tube that empties urine from your bladder, begins to thin.
- Your pelvic floor, the group of muscles that supports both your urethra and bladder, weakens.
Urinary Incontinence Treatment What You Can Do Right Now
Bladder issues are like so many other health-related concerns the sooner you attend to them the easier they are to treat. You may want to try the following for incontinence:
Talk with your healthcare provider. If you are noticing any urine leakage or an increased frequency of urination, the first step is to get checked out by your healthcare practitioner. Depending upon the situation, you may find it useful to consult further with a gynecologist, urogynecologist or urologist. Most women suffer from some form of mixed incontinence that usually can be treated with alternative therapies.
Pelvic floor exercises. Incontinence can often be arrested or reversed with simple Kegel exercises alone. You can do them anywhere, anytime and you should.
To do a Kegel, imagine that you are trying to stop yourself from urinating. Practice both short and long Kegels. You can even do an anticipatory Kegel before you sneeze or cough and prevent leakage!
A wonderful added benefit of Kegels is that the increased muscle tone can increase sexual pleasure in both sensation and orgasm.
If Kegel exercises dont seem to be working well for you, you can try insertable cones or balls to help train your PC muscle. Biofeedback practitioners use electronic monitors inside the vagina to help women learn how to identify and tone muscles related to the bladder. Both tools can be very effective.
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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.
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.
Am I At A Higher Risk Of Incontinence At An Older Age
Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. Its important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.
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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.
If youve found that bladder leaks have become a problem for you, whether youre 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.
What Is The Link Between Menopause And Incontinence
On top of hot flushes, night sweats and mood swings, bladder problems are one of the most experienced symptoms of menopause.
Whether itâs needing to go more often or accidentally weeing yourself, urinary incontinence is really common during perimenopause and menopause â but itâs definitely not spoken about enough.
Some signs you may be experiencing incontinence during menopause are:
Leaking urine when you cough, sneeze, laugh or exercise
Feeling a sudden, intense need to pass urine
getting up often during the night to pass urine
frequent urinary tract infections
Although incontinence is often a byproduct of menopause, bladder leaks donât have to be a ânormal part of ageingâ. Just because menopause is unavoidable doesnât mean you have to suffer the symptoms in silence.
Keep reading to learn more about incontinence, why itâs common in menopause, and how you can manage bladder leaks.
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Tips To Help Support Your Bladder During Menopause
So, what can you do to help your bladder?
One really important thing, and please bear this in mind, if you are passing blood when you’re going to the toilet, this needs medical attention so please do contact your doctor or your local surgery if this is happening because this is something that really does need some attention.
What Causes Urge Urinary Incontinence
Urge urinary incontinence is the involuntary loss of urine associated with urgency , or being unable to delay passing urine until a convenient time.
The uncontrollable need to pass urine occurs due to overactivity of the muscle of the bladder wall. It is associated with increased urinary frequency, urgency and needing to wake up multiple times during the night in order to pass urine. Typically, the feeling of urgency can be associated with daily activities, such as when you put the key in the front door, or when water is running. This is also known as overactive bladder syndrome. Some people with overactive bladder syndrome can feel urgency, but not actually leak any urine.
Mixed urinary incontinence is the involuntary loss of urine associated with both urgency and any physical exertion, or when sneezing or coughing.
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Managing Urinary Incontinence During Menopause
Incontinence may be common after menopause, but its not something you have to live with. Depending on your symptoms and personal preferences, urine leakage can be managed with lifestyle changes, medication, surgery, or a combination approach.
To find the right strategy for you, start by talking with your healthcare provider. While bringing up urine leakage can be uncomfortable, your doctor can be an ally for finding effective, personalized solutions. Youre not alone in this incredibly common complaint, says Dr. Dweck.
For many women, Kegel exercises are an effective way to strengthen the pelvic floor muscles. Giving the bladder more pelvic floor support can help prevent leakage as well as provide other benefits, like more satisfying sex and preventing pelvic organ prolapse. Experts recommend performing Kegels on an empty bladder and working up to five sets of 10 repetitions per day.5
Another simple strategy: Taking a proactive approach with your drinking and bathroom habits. Both alcohol and caffeine can act as diuretics and cutting back on your consumption can mean having to go less often. Slowly lengthening the time in between bathroom trips and double voiding a technique whereby you urinate, then waiting a few minutes to urinate again to make sure the bladder is completely empty can also be helpful.
Dont Let Menopause And Bladder Leakage Stop You
Menopause alone is not the only cause of bladder control problems but its one of the biggest ones. If bladder leakage is concerning you, then consider what you can do to reduce its impact. You dont have to live in fear or walk around believing that youre alone. At least 1 in 4 women over 35 have weak bladders and they live normal lives, so you can too.
Got advice for other menopausal women on how to manage the urges and drips? Share it in the comments!
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Talk To Your Doctor About Hrt
HRT in the form of local oestrogen which is applied inside your vagina as a cream or pessary may be helpful for easing leaks. However, systemic HRT isnt recommended as a treatment for urinary incontinence.
If youre taking systemic HRT and youre concerned that its making leaks worse, talk to your doctor. They may be able to work out if its part of the problem. And if HRT is important for managing other menopausal symptoms, they may have other suggestions, such as trying a different type.
Symptoms Of Urinary Incontinence
Urinary incontinence has several types but there are two notable forms. The symptoms a woman experiences can tell a lot about which type she has, as well as what can be done to manage the problem.
- Stress incontinence is the most common type of incontinence, affecting up to 88% of those with urine leakage.4 Caused by weakened pelvic floor muscles, stress incontinence is marked by leakage that occurs from increased abdominal pressure think sneezing, coughing, laughing, bending, or lifting heavy objects.
- Urge incontinence or overactive bladder is caused by overly active or irritated bladder muscles. Its characterized by sudden, frequent urges to urinate.
In addition to leakage, some women with incontinence experience other changes to the way they urinate too. Some may notice a change in the stream force or direction of their urine, as well as urinary spraying or a sensation of relaxation of the bladder or urethra, Dr. Dweck says.
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Bladder Leakage And Menopause
Although its not often talked about, bladder leakage is common for those going through menopause. In fact, a study of 3000 women ages 42 to 64 revealed that 68 percent of the women in the group experienced bladder leakage at least once a month! That means youre in good company and probably that this is something that impacts a lot of your friends, too. With a decline in estrogen, the urethra becomes less elastic, thinner, and drier, which ultimately leads to an increased need to go.
Estrogen plays a significant role in pelvic collagen synthesis and elastin, which provides strength and flexibility to the pelvic floor muscles. So, having less estrogen results in decreased strength of the pelvic supportive ligaments. And weakened pelvic floor muscles lead to those dreaded leaks.
Two other common causes of leaks during menopause include:
- Weight gain The middle age spread occurs from a mix of hormonal changes, lifestyle, and genetics. Muscle mass decreases and fat increases with age. This extra weight not only bums us out but can put strain on the bladder too.
- Pelvic prolapse This occurs when the bladder, bowel, or uterus begins sagging down against the pelvic floor. The depletion of estrogen during menopause thins the support structures that hold the pelvic organs in place, which causes them to fall. This extra stress on the pelvic floor increases the urge to go.
Urinary Leakage Bladder Problems And Menopause
Urinary incontinence, painful urination and urinary tract infections are common at menopause and perimenopause. Incontinence should not be seen as inevitable – there are plenty of solutions to help improve or cure bladder symptoms. We have 8 solutions for you to try out.
Don’t suffer in silence – seek help for troublesome symptoms at menopause
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Menopause And Urinary Incontinence
You dont have to accept occasional bladder leakage as another side effect of menopause or aging. In many cases, there are things you can do to stop and even prevent urinary incontinence.
Urinary incontinence is also known as loss of bladder control or involuntary urinary leakage. Millions of women experience it, and the frequency of UI tends to increase as you get older. The loss of control can be very minor. For example, you might only leak a few drops of urine when you laugh, exercise, cough, or pick up heavy objects. Or you might experience a sudden urge to urinate and be unable to keep it in before reaching the restroom, resulting in an accident.
You can experience UI throughout your life, but most episodes are the result of pressure or stress on the muscles that help you hold or pass urine. Hormone changes can also affect your muscle strength in the pelvic region. Therefore, UI is more common in women who are pregnant, giving birth, or going through menopause.
Estrogen is a hormone that helps regulate your menstruation. It may protect against heart disease and slow bone loss. It also helps keep your bladder and urethra healthy and functioning properly. As you near menopause, your estrogen levels begin dropping. This lack of estrogen may cause your pelvic muscles to weaken. They may no longer be able to control your bladder as they did before. As your estrogen levels continue to drop throughout and after menopause, your UI symptoms may become worse.
Urinary Incontinence In Women: What You Need To Know
Urinary incontinence is the accidental loss of urine.
Over 25 million adult Americans experience temporary or chronic urinary incontinence.
This condition can occur at any age, but it is more common in women over the age of 50.
There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.
Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
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What Is The Treatment For Urinary Incontinence
Specific treatment for urinary incontinence will be determined by your doctor based on:
Your age, overall health and medical history
Type of incontinence and extent of the disease
Your tolerance for specific medications, procedures or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Bladder training: Teaches people to resist the urge to void and gradually expand the intervals between voiding.
Toileting assistance: Uses routine or scheduled toileting, habit training schedules and prompted voiding to empty the bladder regularly to prevent leaking.
Diet modifications: Eliminating bladder irritants, such as caffeine, alcohol and citrus fruits.
Pelvic muscle rehabilitation :
Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence.
Biofeedback: Used with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.
Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles.
Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions.
Consult your doctor with questions regarding the management and treatment of urinary incontinence.
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Common Causes Of A Menopausal Sensitive Bladder
Here are some of the reasons why you may be experiencing urinary incontinence during menopause:
- Weak pelvic floor muscles. During menopause, your pelvic floor muscles tend to weaken naturally. Weaker muscles can mean less bladder control and more frequent urination in women.
- Prolapse. A prolapse is a sagging down of organs against the pelvic floor. Some women who have prolapse describe feeling a lump in the vagina where an organ is sagging down. That organ may be the uterus, bladder or bowel. A prolapse strains your pelvic floor.
- Less bladder elasticity. The base of your bladder can lose elasticity over time and have trouble stretching to accommodate your bladder as it fills. As a result, your bladder is irritated as it fills, causing an âoveractive bladderâ sensation that makes you feel like you have to go more frequently.
- Estrogen depletion. With the onset of menopause, estrogen is no longer produced by your body. When this happens, your body is more susceptible to incontinence because there isnât enough estrogen to help keep the tissues around your bladder strong as they were pre-menopause and working well.
- Weight gain. With all the changes happening in your body during meonapuse, itâs not uncommon for women to gain weight. Since your pelvic floor muscles support much of your body weight, any excess weight further strains these muscles, so they may not be able to support your bladder as they should.
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Key Points To Take Away From This Blog:
- Bladder problems are very common during menopause, as fluctuating hormones and age can both impact the bladder at this time
- Other menopause symptoms and conditions can all put extra pressure on the bladder
- There are many signs that can indicate bladder problems, including sudden urges to urinate and needing to urinate during the night
- Drinking more water and less irritating drinks such as caffeine is important
- Toilet habits such as not rushing and cleaning carefully can also help.
Until next week, take care.