Do you have to plan out your day in accordance with the proximity of a bathroom? Are you constantly delaying consumption of liquids in order to avoid a situation where you are dashing for the restroom? And are you between the ages of 40 and 55? Then you may be one of the many women who have an overactive bladder (OAB) associated with menopause and age.
More than 17 percent of women in the United States have an overactive bladder. The difficulty determining just how many women have OAB is due to the fact that the problem remains under-reported. Although some women do not feel comfortable talking to their doctors about the symptoms, help is available and urologists are always ready to listen.
An overactive bladder associated with age has a very specific relationship with menopause. During perimenopause, the period leading up to menopause, and menopause itself, the level of estrogen begins to drop significantly. Pre-menopause amounts of estrogen are used to keep the tissues of your bladder and urethra healthy, so if these necessary amounts begin to decline, then the bladder is at a higher risk of developing problems. If you have begun to notice dryness and sensitivity during sex, it’s likely you’re at risk for bladder problems as well. Just as tissues of the vaginal wall begin to thin and dry out, so does the tissue that lines the bladder, leading to a more sensitive bladder susceptible to “hair-trigger” releases.
Further, the lack of estrogen may lead to the pelvic muscles to weaken. Strong, functioning pelvic muscles are necessary for maintaining bladder control.
Several treatment options exist for an overactive bladder associated with menopause. The first is to avoid foods in your diet that may irritate the bladder. These foods include coffee and black tea, citrus fruits and juices, chocolate, regular and diet sodas, alcohol, spicy foods, tomatoes and tomato-based foods and sauces, artificial sweeteners, and vinegar and vinegar-based salad dressings.
You may also try to include several specific foods in your diet in order to protect your bladder from irritation and urges. These foods include eight glasses of water spaced throughout the day, milk (cow, almond, or soy), and probiotic supplements (which help control yeast growth and promote a healthy bladder).
Kegel exercises are often recommended for those women with OAB. These exercises are used to control the bladder’s ability to hold in urine by strengthening the pelvic floor muscles. To perform the exercise, squeeze and hold the pelvic muscles and then relax them. A nurse or physical therapist who specializes in pelvic floor strengthening can also help with exercises.
Bladder retraining may also be necessary. If you have OAB, your bladder muscles have been conditioned over time to influence the sudden need to urinate. You may retrain your bladder by timing visits to the bathroom according to a strict schedule, gradually extending the intervals between bathroom visits. A therapist may also teach you ways to distract yourself between bathroom visits. Results from retraining usually take at least six to eight weeks to emerge.
Estrogen therapy is a possibility for some. If the bladder symptoms first appeared during perimenopause or if you’re experiencing other menopause-related symptoms, your OB/GYN may help you control the symptoms with hormone therapy. A ring or cream application containing vaginal estrogen has been found to be extremely effective in treating OAB. Vaginal estrogen application is different from and should not be confused with systemic hormone therapy, which uses oral hormones and has more risks than the vaginal creams.
If you believe you have menopause-related OAB, talk to your doctor. Many other treatments do exist, including weight loss, biofeedback, sacral nerve stimulation surgery, and/or other medications. Your doctor will be able to determine the best treatment option for you.