Urinary Incontinence And Menopause

December 23, 2009

You lay awake half the night worrying that if you go to sleep you will wet the bed. Going out anywhere is a nightmare, especially since the fear of losing control of your bladder leaves you not only distressed but embarrassed beyond redemption. At this point, incontinence diapers are out of the question. What is going on and what can you do about it?

It's Common With Menopause

Stress incontinence, or sudden urine loss (as it is known in the medical profession) is the most common type of incontinence in women. It is also a common "side-effect" of menopause. When the female hormone, estrogen, takes a massive dive after menopause, the muscles that keep the bladder strong begin to relax and soften. Estrogen also has an effect upon the health of the urinary tract. All along, we thought that estrogen was only about ovaries, uteruses, and babies.

HRT-Not The Panacea It Was Thought To Be

Hormone replacement therapy worked well in dealing with these effects of menopause because they are rich in estrogen and progestin. However, the large clinical trial that took place in July 2002, called the Women's Health Initiative, released findings that put HRT on the back burner. The hormones available in HRT were found to increase the risk of breast cancer, coronary heart disease, stroke, and pulmonary embolism. Nothing is worth that kind of risk.

The mindset was that if a woman could only take HRT, then her bladder problems (as well as myriad other discomforts associated with menopause) would be over. However, two separate studies gave contrary results to this "foregone conclusion." The Nurses Heath Study showed that HRT actually increased the risk of developing urinary incontinence, regardless whether the hormones were taken orally or absorbed through the skin. This finding was corroborated by a research study on older women completed in Australia.

There's More Than One Way To Deal With This

This condition is embarrassing, to be sure, but if there is any solace, it can be taken in the fact that nearly 40% of all women going through menopause encounter this problem in one form or another. Most women use sanitary napkins as a means of defense, but there is a better way. Or, should we say, better ways. Pelvic exercises to strengthen the muscles of the pelvic floor, physical therapy, collagen injections around the urethra, insertable devices, and minor or major surgery are all options.

You might also check to be sure there isn't another underlying cause for the problem, such as a bladder infection, medication side effects, and abnormalities with the urinary tract, neurological disorders, or food disagreements that are causing the situation.

Kegels - Not Just For Post-Pregnancy Restoration

Perhaps the most effective way to deal with urine leakage is by using an exercise you may have used after you gave birth to your babies. That's right - Kegels! The pelvic floor muscles act like a hammock or net, which supports the organs of the pelvis, including the bladder. The muscles also encompass the openings of the vagina, anus, and urethra. If the muscles are weak and do not control the areas around the urethra properly, then leakage occurs. When estrogen levels decrease, muscle strength does as well, leaving you vulnerable.

The method of performing Kegels can be found with instruction and diagrams on the American Physical Therapy Association (APTA) website. It takes focus and practice, but once you have the technique down, you can do these exercises two or three times a day. In no time at all, leakage will be a distant memory.

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