Menopause

One of the common symptoms of menopause is a change in bladder function, especially when the menopause occurs quite late in life i.e. after the age of 55. Some of these changes may simply be due to old age however some changes in function do occur as a consequence of declining oestrogen production which is characteristic of menopause.

Oestrogen has a number of functions and so the loss of production that comes with menopause can affect many of the body's systems, including the urinary system. In this case oestrogen helps to keep the muscles in the walls of the bladder toned and strong in addition to keeping the sphincter at the bottom of the bladder taught. Thus when the concentration of oestrogen falls in the body the bladder muscles and the sphincter, which has the job of stopping leakage, lose their tone thus resulting in stress incontinence. Not every woman will experience incontinence however many do and they often feel embarrassed that they leak urine when they sneeze or laugh hard.

It is estimated that around 40% of postmenopausal women suffer with some degree of urinary incontinence and so doctors are undoubtedly used to seeing the problem. It has been found that HRT can make the problem worse and so if you are currently using HRT it may be that it is this that is causing your incontinence. Talk to your doctor and see if there are any other HRT options which may not affect your bladder control.

The decline in oestrogen levels can also affect the health of the urinary tract and so it may be that you are more susceptible to infections. If left untreated these can spread to the bladder and this can seriously affect bladder function and the amount of control you have over the organ. All infections should be treated as soon as they are noticed, especially in postmenopausal women.

Many women who suffer with a loss of bladder control following the menopause simply turn to sanitary protection however there are other options available. If the problem becomes severe then it is possible to have minor surgery which pulls the sphincter taught, thus stopping leakage. Alternatively there is the option to have collagen injections that again help the sphincter and the muscles of the bladder remain toned and tight. If you don't want surgery then pelvic floor exercises can reduce the problem dramatically and if these exercises are started early in life then incontinence following the menopause is rarely an issue.

The bladder function problems that occur after menopause can be aggravated by a number of factors including:

• Constipation.
• Urinary tract infections.
• Excessive consumption of caffeine, citrus juices and alcohol.
• Excessive consumption of highly spicy foods or foods high in artificial sweeteners.
• Certain families of drugs.

It is important that you find the cause of your urinary incontinence and identify any factors that might be making it worse before you decide on a course of treatment because when the aggravating factor is taken away the problem may resolve itself.

Urinary incontinence is nothing to be embarrassed about, especially because there are so many ways of treating and avoiding it. By starting pelvic floor exercises early and cutting down on any substances which may amplify the problem many women learn to control urinary leakage and bladder function, or at least reduce the problem to the point that it becomes bearable and therefore have one less thing to worry about during menopause.

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