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TWC #032: Bladder problems during the menopause

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Bladder problems during the menopause

A common problem during the menopause is maintaining bladder control. Changes in your body can make you feel like you’re losing control. Today you will learn how targeted measures and self-care can help you regain control of your bladder during the menopause.

Why does the bladder weaken during the menopause?

At this stage of life, the ovaries no longer produce oestrogen, which is vital during puberty, the menstrual cycle and pregnancy. Without this hormone, your body has the opportunity to recover from the stresses and strains of these phases.
In addition to the familiar symptoms such as hot flushes, night sweats and mood swings, other changes can lead to problems with bladder control, in particular:

  • 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 muscles that support both your urethra and bladder, become weaker.
What bladder problems could occur?

The most common bladder problems that women face during and after the menopause include

Nocturnal urination
Some women wake up several times during the night with the urge to urinate. The urge usually comes very quickly and unexpectedly. This is also known as an «irritable» or «overactive» bladder.

Stress incontinence
You may leak a few drops of urine when coughing, sneezing or laughing. Leakage can also occur when lifting heavy objects or putting pressure on the bladder.

Painful urination
After the menopause, there is an increased risk of urinary tract infections (UTIs), which can cause a burning sensation when urinating.

What else can lead to discharge?

The menopause is not always the only reason for bladder problems. Muscles can lose strength over time or be weakened by childbirth. Diseases such as diabetes or multiple sclerosis can cause nerve damage, which in turn can lead to bladder problems. Medication, such as some antidepressants and painkillers, can also affect bladder emptying. In these cases, it is advisable to consult your doctor. She may be able to change your dosage or prescription.

What can you expect at the doctor’s appointment?

Your GP or gynaecologist can help you find the cause or refer you to a urologist or urogynaecologist who specialises in urinary tract problems or pelvic floor disorders. Investigations may include a pelvic examination and tests for infections. The different tests that are used are

Bladder ultrasound
This painless imaging procedure allows the doctor to assess complete bladder emptying.

Physical urine stress test
The bladder is filled with water and you are asked to stand up and cough or walk to see if urine comes out.

Urodynamic examination
This test checks how well your bladder can store and release urine. You will be asked to empty your bladder and then a thin tube will be inserted through the urethra into the bladder to check if there is any urine left.

During this examination, the inside of your bladder is examined. You will be anaesthetised so that you do not feel any pain. After you have been anaesthetised, the doctor will insert a long, thin, illuminated tube with a lens into your urethra.

What can you do yourself?
The measures depend on the type of incontinence, but small changes can help you regain control of your bladder:

Watch what you drink
Coffee, tea, soda and alcoholic drinks can fill the bladder quickly and cause leakage.

Limit your fluid intake in the evening
If you wake up frequently at night to go to the toilet, reduce your fluid intake in the evening.

Maintain a healthy weight
Being overweight increases pressure on the bladder.

Strengthen your pelvic floor
Kegel exercises, where you repeatedly tense and relax your pelvic floor muscles for a few seconds, can be effective. Try to do three sets of 10 Kegel exercises a day.

Schedule your toilet visits
By planning toilet visits on a fixed schedule, e.g. every hour, you can regain control of your bladder muscles. Gradually increase the intervals as you see improvements.

How is incontinence treated?
Your doctor has various options for treating incontinence:

Biofeedback therapy
A therapist can use computer graphics and sounds to show you when you are exercising your pelvic floor muscles correctly. Over time, this can help to strengthen the muscles around the bladder and urethra.

Electrical stimulation
A tampon-like sensor is inserted into your vagina and weak electrical currents stimulate your pelvic floor to contract. Over time, this device can help you to hold urine better.

Your doctor can fit you with a ring-shaped device that is inserted into the vagina. It presses against the urethra and prevents urine from leaking.

Vaginal oestrogen cream
A low dose applied to the inside of the vagina or urethra can help with stress or urge incontinence.

Prescription medication
A group of medications called antispasmodics can block the signals that cause muscle spasms in the bladder, leading to urinary leakage.

If other treatments are not effective, surgery may be considered to lift your bladder or support the urethra. This is particularly advisable for stress incontinence, but may be less effective for an overactive bladder.

You can tackle bladder problems. Try our tips and if you get stuck, see your doctor.

Stay positive and mindful!

If you need personalised advice or support on your journey through the menopause, contact The Women Circle here.

In our next edition, again on Saturday 9am, we will be covering more aspects of menopause and women’s health. Stay informed and feel good during this special phase of your life.

Products for the menopause section

We’ve all been working towards it. Now the time has come. We have launched our three new products developed with pharmacists and doctors.

We have taken the three most common symptoms and carefully selected herbal extracts to treat them.

The three symptoms are

  • Mood swings
  • Sleep disorders
  • Hot flushes

On our Meno Health product page you will find all the information about the products including studies and detailed explanations.

We are looking forward to your feedback.

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If you would like to get in touch with us, please get in touch.

We are here for you.

Joëlle & Adrian

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