Urinary Incontinence after Menopause, causes and treatment options
Urinary incontinence refers to an inability to control the leakage of urine. Urinary incontinence can be small and sporadic, or heavy and frequent. Menopause is a big time of change in every woman’s life. One thing you may notice is more difficulty with bladder control.
You may know this life shift comes with hot flashes, night sweats, and mood changes. But some other changes can lead to bladder control issues for some women. Increased frequency of urination, urinary incontinence/leaking, painful urination, and nighttime peeing are common symptoms of menopause. These can be brought on by the laxity of muscles caused by changes in hormone levels.
Types of Urinary Incontinence:
Overflow urinary incontinence
Slow, minor leakage after urinating. This can occur when the urethra is blocked or when the bladder muscles fail to completely empty the bladder.
Urge urinary incontinence
Also known as the overactive or spastic bladder, urge incontinence is leakage that results from a strong, immediate urge to urinate. This happens when a muscle spasm contracting the bladder overpowers the sphincter muscles that regulate the flow of urine through the urethra.
Stress urinary incontinence
This is leakage that is caused by the physical stress of coughing, sneezing, laughing, or exercising. Or you might notice leaking when you’re lifting something heavy or doing something that puts pressure on your bladder. Stress incontinence is usually due to the deterioration of the tissues and muscles that support the urinary organs.
Mixed urinary incontinence
Exhibiting symptoms of both urge and stress urinary incontinence.
Symptoms of Urinary Incontinence During Menopause
Urinary incontinence, bladder control problems are common for women going through menopause.
After the end of your menstrual cycles, your body stops making the female hormone estrogen. In addition to controlling your monthly periods and the changes during pregnancy, estrogen also helps keep the lining of the bladder and the urethra healthy.
As we age, many factors can weaken the pelvic floor muscles responsible for the bladder control resulting in urinary incontinence. This includes damage during pregnancy, childbirth, and weight gain.
Women with urinary incontinence can experience symptoms beyond leakage. It’s important to note which symptoms are affecting you so that you can relay the information to your gynecologist. Some symptoms include:
- Frequency – Urinating more often than normal
- Urgency – The urge to urinate, even if the bladder is empty
- Feelings of pressure or discomfort in the lower abdomen
- Dysuria – Painful urination or burning while urinating
- Nocturia – The need to get out of bed to urinate several times a night
- Enuresis – Urinating the bed while asleep
Causes of Urinary Incontinence
Many different medical conditions may cause urinary incontinence. Some of these conditions are easy to treat, while others may require intensive intervention or have long-lasting effects.
Certain medications
Some medications have urinary incontinence as a side effect. These drugs are also known as diuretics. Most patients regain control of their bladder once they are off the medication.
Urinary tract infections (UTIs)
Urinary tract infections are fairly common in women. There are some preventative measures you can take to reduce your risk of a bladder infection or a UTI, and they can usually be treated with antibiotics.
Abnormal growths
Polyps, tumors, and bladder stones may cause urinary leakage, especially urge incontinence. These growths can usually be treated with the help of your doctor.
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Abnormalities in the urinary tract
A urinary fistula is an abnormal opening between a urinary organ and another proximal organ. Urine may leak out of this abnormal opening (i.e. through a fistula in the vagina).
Pelvic organ prolapse.
A healthy pelvis contains strong tissue that supports the organs and keeps them in place. In some patients, these tissues and muscles can weaken and cause the bladder, urethra, uterus, or rectum to prolapse, causing urinary leakage and other problems. This condition is sometimes treated with surgery, or with a supportive device known as a pessary.
Neuromuscular issues
Urinary incontinence is sometimes caused by a lapse in the brain’s ability to communicate with the bladder and urethral muscles.
Other issues
Condition like diabetes or multiple sclerosis can cause nerve damage, which in turn can also cause bladder problems.
Diagnosing Urinary Incontinence
Because urinary incontinence could be an indication of several very different medical conditions, diagnosing the cause can be tricky. If you’re having difficulty controlling your bladder during the day or night, make an appointment with your women’s health care provider.
It is a good idea to keep a diary of your symptoms, noting the time of day and amount of urine you leaked or voided. If you experienced a leak, write down what you were doing at that time. You’ll also want to take note of your liquid intake and any medications you’re using.
At your appointment, your doctor may conduct a combination of tests, including:
Pelvic exam
Your doctor will check for physical abnormalities or any other possible causes of your incontinence.
Stress test
Your doctor will have you cough with a full bladder to observe any leakage.
Postvoid residual volume test
After urinating, your doctor will use an ultrasound or a catheter to measure the amount of liquid left in your bladder.
Dye test
Your doctor injects a special dye into your bladder and has you wear a sanitary pad. The amount of dye leaked onto the pad can help your doctor diagnose the severity of your incontinence.
Cystoscopy
Your doctor inserts a narrow, flexible tube into your urethra. The lens at the end allows your doctor to see inside your urinary tract and bladder.
Urinary Incontinence Treatment Options
Depending on the cause of your condition, you may have several options to treat your urinary incontinence.
Some cases of urinary incontinence can clear up with a few lifestyle changes. These include:
- Drinking less fluid, especially caffeinated drinks
- Quitting smoking
- Losing excessive weight (for overweight women)
- Keeping a healthy weight
- Avoiding constipation, through diet changes and supplements
- Treating stressors such as chronic coughing
You can also talk to your OB-GYN about therapeutic and medical interventions, such as:
Physical therapy
Physical therapy for urinary incontinence can include a few different strategies. You may be asked to change your fluid intake and practice Kegel exercises to strengthen your pelvic floor muscles. Your physical therapist will also show you techniques for bladder training for pelvic muscles. This is to reduce the frequency of the urge to urinate to normal levels (about every 4 hours during the day and between 4-8 hours at night). Your therapist may employ a technique called biofeedback to teach you how to monitor your body’s natural signals.
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If you believe you are experiencing symptoms of, or suffering from Incontinence and Menopause, or have questions about it, please see your doctor.
We also invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863- 6700.
Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.