The Menopause and Incontinence

There are many perks with getting older. The life experience you gather often gives you a good sense of self-belief and what’s really important in life. Maybe you have grown-up children and time to do all of the things you put aside during the years with small children or the hectic beginning-of-a-career stage? Menopause doesn’t have to stand in your way from doing what you love – but there are a couple of things that can be useful to know about during this new period in life.
Most people have heard about common symptoms of menopause, but a topic that is less discussed is how menopause can affect the urinary tract and bladder. In this article we will go through just that along with a couple of treatment options that can be helpful, and ease some of the changes in your body.

The symptoms of menopause

Going through the menopause, you probably know about the hot flushes and possible mood swings. But did you know that there are indications that the menopause might also affect your ability to hold back urine leaks? 
 
In particular, there’s a reduction in the quantity of oestrogen in the genital and lower urinary tract area and this can cause the vaginal and urinary tract tissue to become drier, thinner and less elastic. Pelvic floor muscle degenerate when they are not stimulated by oestrogen. Generally, combinations of age, childbirth, bodyweight and hormonal factors can increase the risk of problems with urinary incontinence or urgency feelings.
 
Read more about menopause and incontinence

How do changing oestrogren levels cause incontinence

The amount of oestrogen varies throughout life, but low levels are typically seen in young girls and women approaching menopause. Oestrogen affects many organs and parts of the body, like the brain, skeleton, uterus, and vagina. It might also be one of the reasons why many women experience incontinence during this period of life. Science hasn’t proved exactly why incontinence during menopause happens, but a valid guess is that it’s due to the lowered levels of oestrogen which can affect the urinary tract and pelvic floor muscles.

Decreased oestrogen levels can cause the following effects:

1. Loss of tissue condition 
Vaginal and urinary tract tissue can become drier, thinner and less elastic (pelvic floor muscles degenerate when they are not stimulated by oestrogen). Generally, combinations of age, childbirth, bodyweight and hormonal factors can lead to this condition and increase the risk of problems with urinary incontinence or urgency feelings. 

2. Change in pH-environment 
Lactobacilli bacteria normally present in the urinary tract create a low pH environment which protects against infection. With age, the level of lactobacilli bacteria is lowered and so does the mucus production. Levels of pH can rise and the mucosa gets drier. This increases the risk of a urinary tract infection since the bacteria find it easier to attach and thrive. Infection (UTI) is also a risk for urinary incontinence. 

You can read more about urinary tract infections here.

How to treat menopause and incontinence

Oestrogen treatment

Oestrogen treatment in the form of creams and vaginal suppositories is one way to manage symptoms, as these treatments provide increased delivery of blood to the tissue. Locally administrated oestrogen adds moisture, making the mucous membranes of the vagina and urinary tract thicker, more acidic and less delicate. It improves the mucus defense against infections which is also reducing the risk of irritation and urinary tract infection. In contrast, oestrogen administrated as pills might worsen urinary incontinence

Pelvic floor muscle training 

Since your pelvic floor muscles are important to improve bladder and bowel control and prevent leaks it is essential to keep up the strength in this muscle group. Add Kegel exercises to your daily routine. A few minutes of pelvic floor training a day can lessen the risk for leaks or even make them go away entirely. 

 

If you feel that you need more help and support with your symptoms during menopause, don’t hesitate to contact a professional. There is help available. Then continue learning, read our guide on how to deal with leaks during the menopause.