While hot flashes, night sweats, difficulty sleeping, and mood swings are common symptoms of menopause, some women also experience bladder control problems. If urinary incontinence is one of the menopausal symptoms you suffer from, you may find it helpful to know more about how declining estrogen levels can bring about changes in bladder function. Understanding the why can help you choose from the self-help measures and available courses of treatment your doctor recommends to regain control of your bladder.
Changes Your Body Undergoes
Bladder issues women sometimes face both during and after menopause include overactive bladder, painful urination, the need to get up several times throughout the night to go to the bathroom, or leaking urine when coughing, sneezing, exercising, or lifting something heavy. The pelvic floor muscles, which support your bladder and urethra, may start to weaken as you age. A decrease in your body's estrogen levels following menopause causes pelvic muscles and connective tissue to thin and sag.
When the urethra—the tube that carries urine from the bladder for excretion—loses muscle tone and strength, bacteria can flourish, making you more susceptible to bladder or urinary tract infections. In severe cases, inflammation may damage the lining of your bladder.
As your body produces less estrogen, vaginal tissue also becomes thinner and less elastic. Dry and irritated vaginal tissue can cause a burning sensation or pain when you urinate.
Tests Doctors Use to Diagnose Urinary Incontinence
Since treatment depends on the type of urinary incontinence you have, following a pelvic exam and labs to test for urinary-tract infections, your doctor may need to order additional diagnostic tests to identify the source of your urinary incontinence. He or she may order multiple tests to determine whether menopause or something else is causing your bladder problems, since medications, such as antidepressants, and certain health conditions, including diabetes, can also lead to bladder problems.
A bladder ultrasound is a painless test that shows the doctor the size of your bladder, whether there is a blockage present, how much urine your bladder holds when it's full, and if it empties completely when you urinate. Your doctor may instruct you to drink lots of fluids before the exam so that your bladder is full at the time of the ultrasound.
A bladder stress test looks to see if you accidentally leak urine. If your bladder isn't already full, a technician will slowly fill your bladder with water. Afterward, you will be asked to stand up and cough or walk a few steps to see if urine leaks.
Cystoscopy—a more invasive diagnostic procedure—requires local or general anesthesia so that you don't feel pain as a doctor inserts a long, thin tube into your urethra. The flexible tube, which has a light and lens at the end, similar to a telescope, allows the doctor to look inside your bladder to check for possible causes of overactive bladder.
Treatment to Get Back Bladder Control
Along with biofeedback therapy, electrical stimulation, or antispasmodic medicines your doctor may prescribe, there are things you can do to help improve bladder control.
If you're overweight, losing even a few pounds can help relieve pressure on your bladder. You should also limit consumption of alcohol and beverages such as coffee, tea, and colas, which can cause your bladder to fill quickly and then leak.
Performing Kegel exercises each day helps to tighten weakened pelvic floor muscles. The exercises are simple to do, as you simply tighten the muscles for a few seconds and then release them. If you aren't sure how to do them, imagine that you are stopping the flow of urine and then relaxing. Repeat the exercise several times.
If home and/or other medical treatments for urinary incontinence fail—particularly for stress incontinence—your doctor may recommend a surgical procedure to lift your bladder.
For more information, talk to a doctor at a location like the Charlotte Center for Pelvic Health.