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HEALTH ENCYCLOPEDIA

Diseases & Conditions A - Z
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Menopause and Urinary Incontinence

Women don’t have to accept occasional bladder leakage as just another side effect of menopause or aging. In many cases, there are things you can do to stop and even prevent urinary incontinence.

Overview

Urinary incontinence (UI) is also known as “loss of bladder control” or “urinary leakage.” Millions of women experience UI, and the frequency of involuntary loss of urine becomes more common as you get older. The loss can be very minor—you might only leak a few drops when you laugh, exercise, cough, or pick up heavy objects. Or, you may experience a sudden urge to urinate and can’t keep it in, resulting in an accident.

Women can experience UI throughout their lives, but most episodes are the result of pressure or stress on the muscles and nerves that help you to hold or pass urine. Hormone changes could also affect muscle strength. Therefore, UI is more common in women who are pregnant, giving birth, or going through menopause.

Estrogen, a hormone that helps regulate monthly cycles, may protect against heart disease, and may slow bone loss, also helps keep the bladder and urethra healthy and functioning properly. As you near menopause, your estrogen levels begin dropping. This lack of estrogen may mean that your pelvic muscles are no longer able to control your bladder as they did before, and that urethral tissues may have weakened. As estrogen levels continue to drop throughout menopause and after, UI may become worse. 

A few different types of urinary incontinence are associated with menopause. These include:

Stress Incontinence

The most common kind of bladder control problem in older women is stress incontinence. Weakened muscles can’t hold back urine when you cough, exercise, sneeze, laugh, or lift something heavy. The result can be a small leakage of urine or a complete loss of control. This type of incontinence is most often caused by physical changes that result from pregnancy, childbirth, or menopause.

Urge Incontinence

When your bladder muscles squeeze incorrectly or lose the ability to relax (so that you always feel the urge to urinate even when your bladder is empty), you may experience leaking or loss of control. This is sometimes called “overactive bladder.”

Understanding The Risk

Menopause isn’t the only cause for bladder control problems, but combined with one of the following conditions, your risk for developing urinary incontinence increases.

Drinking Alcohol or Caffeine

Drinks with alcohol or caffeine fill the bladder quickly, which means you have to urinate more often.

Infections

Infections of the urinary tract or bladder may cause temporary UI. When the infection is cleared, UI will likely also be resolved.

Nerve Damage

Damage to nerves can interrupt signals from your bladder to your brain so that you won’t experience the telltale signs that you need to urinate. Therefore, you will not be able to control urination.

Certain Medications

UI can be a side effect of some medicines, such as diuretics or steroids.

Constipation

Chronic (long-term) constipation can affect bladder control. It can also weaken pelvic floor muscles, making it harder to hold in urine.

Being Overweight

Carrying excess weight increases your risk for UI. The extra weight puts pressure on the bladder and can cause UI or make it worse.

Treatment Options

How your urinary incontinence is treated depends on several factors, including the type of incontinence you’re experiencing. Many doctors will begin initial treatments by suggesting possible lifestyle changes. These include:

  • cutting back on caffeine and alcohol consumption
  • gradually retraining your bladder to hold more urine by only urinating at certain, pre-planned times of the day
  • striving to lose weight to reduce the pressure on your bladder and muscles
  • using Kegel exercises to strengthen pelvic floor muscles

Your doctor may recommend more involved treatment options, especially if they don’t think lifestyle changes are helping. These options include:

Medications

Medications can reduce the symptoms of and treat some types of UI.

Nerve Stimulation

Electrical stimulation of pelvic muscles may help a person regain control of the bladder.

Devices

A pessary is the most commonly used device for the treatment of stress incontinence. This device is inserted into the vagina and helps reposition the urethra in order to reduce leakage.

Biofeedback

You can work with a therapist to better understand how your body works and learn how it alerts you that you need to use the bathroom. A wire connected to an electrical patch over your bladder and urethral muscles sends signals to a TV screen that alerts you when your muscles are contracting. By learning when they contract, you may be able to gain better control over them.

Surgery

Surgery to repair and lift the bladder into a better position is often the last resort for UI treatment. It’s reserved for people who couldn’t be helped by other forms of treatment.


Content licensed from:

Written by: Kimberly Holland
Medically reviewed : George Krucik, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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