Tag Archive | "menopause"

Menopause and an Overactive Bladder


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.

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The Relationship between Menopause and Bladder Control


Some women have bladder control problems after they stop having periods (menopause or change of life).

After your periods end and you have been “period-free” for 12 consecutive months, your body stops making the female hormone estrogen. Some scientists believe estrogen may help keep the lining of the bladder and urethra firm and healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

In some women there is only a slight change but for others the muscles weaken to the point where holding back even small amounts of urine is very difficult. The result is urinary incontinence or quite simply, urine leaking from the body before it should.

There are two kinds of urinary incontinence – stress incontinence and urge incontinence. Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence. Urge incontinence means the bladder muscles squeeze at the wrong time or all the time and cause leaks.

According to the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) taking estrogen does little to counter the effects of weakened bladder muscles. There are also concerns about taking estrogen for too long and during your post-menopausal years as there are added risks from taking estrogen for many years. Taking estrogen in small does may help thicken the bladder lining and decrease the incontinence although estrogen will not repair the weak muscles or reverse the effects of declining hormonal levels. Your doctor can suggest many other possible treatments to improve bladder control.

Talk to your health care team. You may have stress or urge incontinence, but other things could also be happening. Medicines and exercises can restore bladder control in many cases. Your doctor will give you a checkup first.

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