Bladder issues in the menopause

It is very common for lots of women to notice changes to their bladder during the menopause resulting in trips to the toilet more often.

At this time our bodies are going through so many changes and the bladder is no exception to this!

During menopause as the estrogen decreases in our body this can have a huge effect on the use of the bladder, bladder valve and pelvic floor muscles and their functionality causing them to become weaker and muscles thinner which can cause them to relax. If the pelvic floor muscles become really weak, then the organs in this whole area can shift sometimes quite dramatically, and that can squash the bladder, making it hold less urine at any given time.

Another thing that may happen is that because our bladder becomes more sensitive and thinner, meaning we can become more prone to repeated bouts of cystitis or other urinary tract infections.

Often people may think that this is just a natural process as we age and lots of women should ‘just get on with it’ but to many it can be quite debilitating and lower their quality of life. BUT there are things we can do help with this situation.

There are 3 main types of Urinary Incontinence experienced during the menopause :

Stress Urinary Incontinence – this is where you could leak urine if your bladder is put under pressure from coughing, laughing, sneezing or exercise
Overactive Bladder – this can often be caused by an irritation to the bladder and give the feeling of urgency and/or frequency to visit the toilet
Overflow Incontinence – When your bladder does not empty fully, this type of UI can show as continuous urine dribbling. You can have a weak urinary stream, feel like urinating at night, and increased urinary hesitancy. This can be caused by underactivity of the bladder muscle.

To help relieve these symptoms and help support our bladders we can:

Drink plenty of water – We know this may sound like you will be going to the loo more but if you do have an infection somewhere you do not want to be reducing your water intake as you could end up being dehydrated. This in turn can then make the urine more concentrated and acidic which would then irritate your bladder further. An indicator that you may not be drinking enough is when you feel a sudden urge to go to the toilet but then only a very small amount comes out. A good tip is to drink lots of water in the daytime then at night a small mouthful of luke-warm water just before bed which should not be enough to increase your nighttime trips.

Pelvic Floor exercises – The use of pelvic floor exercises is a great preventative measure to really help strengthen the muscles in this area ensuring strong and healthy muscles for your bladder and pelvis. You can try out something called Kegel Exercises which are quick and discreet so you can easily do them anywhere. Simply, clench your muscles as if you were holding in your urine for around 10 seconds and relax and keep repeating this process several times a day.

Avoiding alcohol & caffeine – By drinking alcohol and caffeine this can increase the volume of urine your body will make making the loo visits much more frequent which in turn could make your bladder more irritated .

Try Hormone Replacement Therapy (HRT) – If you been informed that your bladder issues are being caused by changes to the tissue of your bladder, urethra, and vagina (Urogenital Atrophy) you could investigate the possibility of using HRT. HRT contains estrogen which helps to improve the muscles in your body but as we age this natural hormone is depleted. HRT can also help if you are suffering from other menopausal symptoms however if your symptoms seem to only relate to bladder/vagina you may want to investigate the use of vaginal estrogen only HRT.

Talk to a Doctor – Talking to a doctor can really help you understand that you are not alone in this journey and that bladder issues are very common amongst lots of women. They can check you for any infections and monitor your glucose and blood levels ensuring that you can rule out other conditions that could cause bladder issues.

Take a look at the below websites for further information

Menopause Symptoms | Bladder Symptoms | My Menopause Centre