WHAT IS MENOPAUSE?
Whether you’re experiencing menopause or about to start, it can be a difficult time for any woman. With hot flushes, mood swings, and irregular bleeding, menopause can also have an impact on your hormone levels that can result in incontinence.
By definition, Menopause occurs when your ovaries no longer produce enough Progesterone and Oestrogen to aid fertility and ovulation. And although that means no more menstrual cycles, the subsequent hormonal imbalance does introduce some physical and emotional symptoms.
So when does it all begin? If you’re a woman in her mid-40s, you’ll begin to experience Menopause symptoms as your ability to have a baby comes to the end.
UNDERSTANDING MENOPAUSE INCONTINENCE
INCONTINENCE DUE TO A LOSS OF OESTROGEN
Oestrogen is a hormone that helps regulate your monthly cycles. It also protects against heart disease, slows bone deterioration, and keeps your bladder and urethra in tip top shape and performing as it should.
However, with the onset of Menopause, your Oestrogen levels start to drop; meaning your pelvic muscles begin to weaken and are less likely to control your bladder. This is a process known as ’pelvic relaxation’. Additionally, your urethral tissues also start to thin. Consequently, as you age, and your Oestrogen levels continue to drop throughout Menopause (and after), urinary incontinence becomes a bigger problem.
WHAT KINDS OF INCONTINENCE IS MOST TYPICAL DURING MENOPAUSE?
Here are the most common urinary incontinence types you may develop with the onset of Menopause.
Stress incontinence — This is one of the most common kinds of bladder control problems in older women. It happens when urine involuntarily leaks with a cough, a laugh, a sneeze, when you’re exercising, or lifting something a bit heavy. Sudden pressure to the bladder walls from these activities can cause incontinence because they squeeze the bladder causing urine leakage.
Urge incontinence — The most common bladder control problem in older people. With Urge incontinence, the bladder spasms and contracts resulting in the sudden, intense, and frequent urge to urinate, followed shortly by an uncontrollable loss of urine. With this condition, urine leaks because your bladder muscles contract at the wrong time (or all the time). This type of incontinence can strike while sleeping, drinking, or while listening to running water.
Overflow incontinence — Characterised by frequent or constant dribbling urine. If you have Overflow incontinence you’ll find yourself unable to empty your bladder fully, which fills up and then overflows, causing leakage. On top of having the sensation of never fully emptying your bladder, when you urinate, you’ll produce only a weak stream of urine. This type of incontinence is prevalent with those who have damaged bladders or blocked urethras, or as a result of nerve damage from diabetes.
WHAT ARE THE TREATMENTS FOR MENOPAUSE INCONTINENCE?
So, what can you do? First off, determining how your urinary incontinence is treated depends on several factors including the type of incontinence you’re experiencing.
Your GP will begin initial treatments by suggesting possible lifestyle changes like:
- Cutting back on your caffeine and alcohol intake
- Retraining your bladder to hold more urine by only urinating at certain, pre-planned times of the day
- Losing weight to reduce the pressure on your bladder and pelvic muscles
- Undertaking a pelvic floor (or Kegel) exercise program which will strengthen your pelvic muscles and provide structural support to the bladder and help close off the urethra.
If your GP thinks lifestyle changes aren’t helping, they may recommend more involved treatment options.
Another great tip
Absurd as it may sound, drinking lots of fluids and emptying your bladder often, is actually quite helpful for incontinence. The thought here is that the act of holding your urine as long as possible before emptying your bladder helps to strengthen the muscles around your bladder and urethra
Read more about treatment options
MANAGING MENOPAUSE INCONTINENCE
HOW ARE BLADDER CONTROL PROBLEMS DIAGNOSED?
In the first instance, your GP will first obtain a detailed medical history and perform a physical exam, including a pelvic exam. To further diagnose a bladder control problem, your urine is tested for signs of infection or other problems.
Your doctor may also recommend you keep a voiding diary to record your symptoms and the situations where you feel the urge to urinate or there is an incidence of leakage. The voiding diary may help narrow the cause of your problem, and help your GP to determine the best treatment options.
WHEN SHOULD I SEE MY DOCTOR?
Your GP should be at the top of the list for people to see about any incontinence problems. They should be able to determine the best way forward. They may also recommend you see a professional who can help you with bladder control. These specialists include:
- A gynaecologist
- A urogynecologist
- A urologist
- A continence physiotherapist
This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek advice from a qualified health care professional with any questions regarding your concerns.