Menopause and changes in the bladder

Why does incontinence occur during menopause?

An older woman’s bladder may get weaker during menopause because her ovaries stop making oestrogen, the hormone that controls her menstrual cycle. This can cause her vaginal tissue to become less elastic, the lining of her urethra to thin and her pelvic floor muscles (which support her urethra and bladder) to reduce.It can also make her bladder less elastic and overstretched, so that it gets irritated when it fills up with urine and becomes ‘overactive.’Oestrogen loss can result in vaginal and urethra dryness, which can put women at higher risk of developing a urinary tract infection as a result of normal bowel bacteria moving into the urethra.

Postmenopausal weight gain is common, putting extra strain on a woman’s bladder and weakening her pelvic floor muscles, creating stress incontinence. Plus, great risk of diabetes can create nerve damage (neuropathy), which means loss of sensation in the bladder, poor emptying and constipation.Many women who have given birth and have had damage to their anal sphincter (muscle around the anus) may also find bowel control problems occur with the onset of menopause.

What are the warning signs for incontinence?

The most common problems older women face during and after menopause are:

• Stress incontinence. She might complain she’s losing a few drops of urine when coughing, sneezing, or laughing, or leaking when she’s lifting something heavy or doing something that puts pressure on her bladder.

• Urge incontinence. The need to urinate comes on fast and unexpectedly. She might complain that she’s not making it to a bathroom in time. This is sometimes called an “irritable” or “overactive” bladder.

• Nocturia. Some women wake up several times in the middle of the night with an urge to urinate.

• Painful urination. After menopause, women are more likely to have urinary tract infections (UTIs).

Any of these problems can interfere with work, social activities, and sexual and personal relationships. Without medical help, they rarely go away and usually get worse over time.

Watch the video below of Phil who gives us 11 of his best tips for a healthier bladder

By Phil Wilkinson
Urology and Continence Nurse

Incontinence post menopause treatment

Five things to help you regain control of your bladder:

1. Eat well. Extra kilos put more pressure on the bladder. We suggest you maintain a healthy, low fat diet to combat the tendency to put on weight during menopause.

2. Drink well. Coffee, tea, fizzy and alcoholic drinks cause the bladder to fill quickly and then leak. If you usually wake in the night needing to go, we advise you to cut back on the amount of fluids you drink during the evening.

3.Exercise regularly. Keeping fit and healthy reduces the potential for weight gain, lowers stress and maintains muscle tone.

4.Tone up your pelvic floor muscles. Click here to see our tips.

5.Practice good toilet habits. We suggest you set scheduled bathroom breaks – say, every hour – to help regain control of your bladder muscles. Once you see improvement, you should try slowly extending the time you head to the toilet.