Menopause, the end of a woman's menstrual cycles, marks the end of fertility. The transition happens because the ovaries stop producing estrogen and progesterone. This hormonal change commonly begins between the ages of 45 and 55 but may happen earlier or later.
Menopause itself does not directly cause urinary or bladder problems. However, the hormonal changes associated with menopause can lead to several urinary conditions:
- Urinary incontinence - Loss of bladder control is common during perimenopause and menopause. When estrogen levels decline, tissues in the urethra and bladder become drier and less elastic. This can lead to stress incontinence, the leakage of urine during physical activity such as coughing, sneezing, laughing, or exercise.
- Urinary tract infections (UTIs) - The drop in estrogen also thins the lining of the urethra, making it easier for bacteria to invade and cause infections. Menopausal women are at higher risk for recurrent UTIs.
- Overactive bladder - Many women experience a frequent and sudden need to urinate during menopause. The urge may be difficult to control. An overactive bladder may have no identified cause or result from UTIs, vaginal atrophy, interstitial cystitis, bladder stones, bladder cancer, or nerve problems.
Some other urinary symptoms associated with menopause include:
- Increased nighttime urination (nocturia)
- Urinating more frequently yet passing less urine
- Pain or burning during urination
- Blood in the urine
- Foul-smelling urine
- Incomplete bladder emptying
What causes bladder problems during menopause?
The exact reasons are unclear, but likely involve:
- Hormonal changes - Estrogen helps keep the lining of the urethra and bladder flexible and supple. As estrogen drops, this tissue becomes drier, thinner, and less elastic. These changes can exacerbate urinary symptoms.
- Aging - The muscles that control the bladder and urethra weaken over time. Conditions like UTIs, diabetes, neurological disorders, prostate issues, constipation, obesity and certain medications can also contribute to bladder problems.
- Genetics - Some women have an inherent predisposition to developing stress or urgency urinary incontinence during menopause.
Can menopausal bladder issues be treated?
Yes, many effective treatments can provide symptom relief, including:
- Lifestyle changes like quitting smoking, doing Kegel exercises to strengthen the pelvic floor muscles, avoiding bladder irritants in food/drink, managing fluid intake, and maintaining a healthy weight. Losing extra weight can significantly improve menopausal bladder problems.
- Vaginal estrogen therapy - Local, low-dose estrogen helps nourish tissues in the urethra and vagina that become thin and dry during menopause. Estrogen can be applied directly to the vagina via creams, tablets or rings.
- Medications - A variety of prescription drugs can relax bladder muscles, block nerve signals, inhibit muscle spasms, kill bacteria, and more. Possible medications for overactive bladder include oxybutynin, solifenacin, darifenacin, mirabegron, Botox injections and antidepressants. Antibiotics treat UTIs.
- Medical devices like pessaries and urethral inserts provide mechanical support for the urethra and bladder neck. They help prevent urine leakage with sudden increases in abdominal pressure.
If you're experiencing new or worsening urinary symptoms around menopause, see your healthcare provider. They can properly evaluate your situation, identify any underlying causes, and create a treatment plan tailored to your needs. Relief is possible!
If you're struggling with menopausal hormone issues, consider contacting Vital Hormones Clinic about bioidentical hormone replacement therapy. It can help mitigate troublesome symptoms like bladder problems using customized treatment plans with plant-based hormones identical to those your body produces. Contact Vital Hormones Clinic today for a consultation.
