The hormone estrogen is partly responsible for maintaining elasticity in the vaginal and urethral tissues. During menopause, the body slows the circulation of estrogen, which thins out the urogenital tissue and weakens the muscles that control the bladder and urinary functions.
Four main bladder control problems that affect women post-menopause
This means getting out of bed several times to use the bathroom at night
A burning or stinging sensation
Leakage that occurs during sneezing, coughing, or heavy lifting
Leakage that occurs when the bladder muscles squeeze seemingly at random or just all the time
Visiting Your OB-GYN about Bladder Control Problems
If you’re having bladder control problems, please feel comfortable speaking openly with your gynecologist about your concerns. Don’t neglect a doctor’s visit just because you assume you know the cause of the problem. Although menopause is usually the most likely culprit of bladder control issues in older women, your doctor will want to rule out other possible conditions.
Your doctor will want to perform a physical exam as well as a pelvic exam, and will want to test for infections. We may ask you to keep a diary of your urinary health – noting the times that you have the urge to urinate or experience a leak.
Treatments for Urinary Incontinence
There are many medical and non-medical recommendations for managing urinary problems. Again, talk with your doctor about which options may work best for you.
- Avoid caffeine and other diuretics
- Train your bladder to hold more urine, and get in the habit of timing your urination
- For obese women, losing weight may increase bladder control
- Practice Kegel exercises. These are very easy exercises designed to strengthen your pelvic floor muscles. The basic idea is that you repetitively squeeze your pelvic muscles as though you were holding urine in. Ask your gynecologist for advice if you’re not sure where to begin.
- Biofeedback, a technique by which patients can learn how to train bodily functions with the help of a therapist and a specialized machine
- Prescription medication, such as Vesicare, Ditropan, Detrol, Toviaz, and Myrbetriq
- Over-the-counter medication, such as Oxytrol
- Medical devices, such as a pessary that can be inserted into the vagina to provide structure to weakened muscles
- Nerve stimulation devices, which can be implanted under the skin to send electrodes to the muscles controlling the bladder
- Botox, which can relax the bladder muscles
- Surgery to correct lax bladder and urethral tissues