The menopause is a natural phase in a woman's life, which can often bring unexpected challenges. One such challenge is bladder weakness or incontinence, an issue many women may not talk about openly. While the connection between menopause and bladder control isn't always discussed, it's a reality for many women. In this article, MoliCare® provide information that you need to know about managing bladder weakness during menopause.
Why Menopause Can Lead to Incontinence and Bladder Leaks
Bladder weakness is not just about the involuntary leaking of urine; it's about the loss of control and the accompanying emotional distress. The decline in oestrogen during menopause affects the urinary tract, leading to the thinning of the urethra lining, reduced bladder elasticity, and weakened pelvic muscles.
While many consider menopause to be associated with hot flushes and mood swings, it’s effect on the urinary tract and bladder and can easily be overlooked. Remarkably, up to 50% of post-menopausal women can face occasional urine leakage. Therefore, it is vital to understand the reasons behind this and look at potential support.
We know that menopause can cause a reduction of oestrogen production, a hormone vital for the health of the bladder and urinary tract. This decline can manifest as vaginal dryness, increased urinary frequency, urgency, and occasional leakage, all of which can lead to "genitourinary syndrome of menopause" (GSM).
Types of Bladder Weakness Linked to Menopause
In this section, MoliCare® explains the types of incontinence that are linked to menopause in women. Understanding the differences between these variations will help you to better understand how each type of incontinence works, and the symptoms that are underlined with them.
Stress Incontinence
Stress incontinence occurs when pressure is put on the bladder. If you have stress incontinence, you may experience urine leaks when you cough, sneeze, laugh, jump, or lift certain objects. Learn more about stress incontinence to develop a better understanding of this type of incontinence.
Urge Incontinence
Another common form of incontinence is known as urge incontinence and can occur when you have a frequent or urgent need to urinate. This can also lead to waking up multiple times during the night to go to the toilet.
Mixed Incontinence
As the name suggests, this is a combination of both stress and urge incontinence. Women experiencing mixed incontinence face challenges from both fronts, making it particularly distressing.
How to Manage Bladder Weakness during Menopause
There are ways in which bladder weakness can be managed alongside menopause, it's best to consult your GP.
- Bladder Weakness Products: Try MoliCare® who offer a choice of slim, discreet absorbent pads or washable and absorbent underwear, especially helpful during physical activities. Unfortunately, menstrual pads are not going to be suitable for bladder leaks, so invest in the right product specifically designed for urine.
- Plan ahead: Before heading out of the house, familiarise yourself with the locations of nearby public toilets. Always keep a change of pads on hand for public toilets.
- Safeguard Your Bed: Consider bed mats or mattress protectors to protect your bed from any accidents or leaks during the night.
Read more about the differences between bladder weakness pads and menstrual pads.
Risk Factors for Bladder Weakness
While menopause can lead to bladder issues, combining it with other factors can increase the risk of urine leaks.
Alcohol & Caffeine Consumption: Drinks containing alcohol or caffeine can stimulate the bladder, leading to frequent urination. Limiting your intake of these liquids will decrease the risk of having urinary incontinence.
Infections: Urinary tract or bladder infections might result in temporary incontinence. Once the infection is treated, symptoms often diminish or disappear.
Nerve Damage: Damage to nerves can disrupt communication between the bladder and brain, affecting the sensation of needing to urinate and impacting bladder control.
Specific Medications: Some drugs, including diuretics and steroids, might have incontinence as a side effect.
Constipation: Persistent constipation can influence bladder function and weaken pelvic muscles, complicating urine retention.
Excess Weight: Being overweight can elevate the risk due to added pressure on the bladder, potentially initiating or exacerbating incontinence.
How to Manage Bladder Weakness During Menopause
1. Pelvic Floor Exercises:
Daily pelvic floor exercises can enhance bladder control during menopause, to learn more read MoliCare®’s guide to pelvic floor exercises – Exercises for women.
2. Bladder Training:
Schedule bathroom visits throughout the day. This helps in gradually increasing your bladder's capacity read more with MoliCare®’s guide to bladder training – How to increase bladder capacity.
3. Lifestyle Adjustments:
- Reduce caffeine and alcohol intake as they increase urination.
- Ensure you drink the right amount of water.
- Shedding extra weight can lessen the strain on your bladder and pelvic area.
- Understand the importance of a healthy menopausal lifestyle for better bladder control by knowing about the best bladder friendly drinks.
Treatment Options for Urge and Stress Incontinence
Many women face the challenges of urgency and frequent urination, disrupting their daily routines. Whilst there are incontinence pads for women, there are also medicinal and surgical solutions available.
Medication for Urge Incontinence:
For those troubled by constant urination urges, antimuscarinic drugs might be the answer. These bladder relaxants can offer relief, especially when combined with pelvic floor exercises and bladder training. Always discuss potential side effects with your doctor.
Surgical Procedures for Urge Incontinence:
If traditional treatments don't alleviate urge incontinence, surgical options might be considered:
- Botulinum Toxin A Injections: Botox injections into the bladder walls can calm overactive muscles. Their effects can last months, with the option for further treatments if required.
- Sacral Nerve Stimulation / Posterior Tibial Nerve Stimulation: This method uses electrical currents on bladder-controlling nerves to manage the bladder muscle. While effective, it's less common due to the success of non-surgical treatments.
Surgical Procedures for Stress Incontinence:
Stress incontinence, or urine leakage during physical activities, can often be managed by strengthening pelvic floor muscles. If symptoms persist, surgical interventions might be explored:
- Colposuspension: This surgical procedure involves lifting the neck of the bladder and stitching it in place. By repositioning the bladder neck, it offers long-term relief from stress incontinence.
- Sling Surgery: Here, a supportive sling, crafted from human or animal tissue or even synthetic materials, is placed around the bladder neck. This acts as a hammock, supporting the bladder and preventing unintentional leakage.
- Urethral Bulking Agents: These agents, when injected, bulk up the urethra walls. By enhancing its size, they ensure the urethra closes more effectively, reducing episodes of leakage.
Multiple Approaches for Managing Incontinence Throughout Menopause:
In summary, there are many ways to manage incontinence during menopause. It requires a multifaceted approach, since women can benefit differently from each option laid out throughout this article, including bladder control training and medication. If symptoms persist, surgical options, ranging from Botox injections to sling surgery, offer viable solutions. It's crucial to consult with your GP to determine the most suitable treatment. For more incontinence protection options, browse our range of MoliCare® incontinence pads and pants for women.
Sources
RACGP. (2017). Genitourinary syndrome of menopause. Australian Family Physician. [online] Available at: https://www.racgp.org.au/afp/2017/july/genitourinary-syndrome-of-menopause [accessed 21/08/23]
