As we age, urinary symptoms such as incontinence (leakage) become more and more likely. This is particularly the case for women who are much more prone to urine leakage then men. Up to 30% of women in midlife experience urinary incontinence.
As menopause approaches, the diminishing estrogen levels can cause the lining of the urethra to thin out. The urethra is the outlet for the bladder. Combined with weakened pelvic muscles due to natural aging, the risk for urinary incontinence is dramatically increased.
The two most common types of urinary incontinence in women are stress incontinence and overactive bladder.
- Stress Incontinence is caused by weak pelvic floor muscles. Leakage of urine occurs after coughing, laughing, sneezing, or lifting heavy objects. This is the most common form of incontinence for perimenopausal women.
- Overactive Bladder is caused by irritated or over active bladder muscles. While there is occasional leakage, the primary symptom is sudden and frequent urges to urinate.
- Mixed Incontinence is when you have both stress incontinence and overactive bladder
In addition to going through menopause, the following factors are known to contribute to urinary incontinence:
- Very high volume of fluid intake, particularly at night
- Being significantly overweight
- Consumption of substances known to irritate the bladder (smoking, citrus juices, and caffeine)
- Prescription medications such as some tranquilizers and diuretics
- Infections of the bladder or urethra
- Other medical conditions such as diabetes, multiple sclerosis, and stroke
- Weakening of the pelvic muscle and ligaments due to natural aging or damage during childbirth
Treatment for Incontinence
While 30% of perimenopausal women experience urinary incontinence, less than one half seek medical help. This is unfortunate, as treatment can often completely cure the condition. Incontinence is not a natural, inevitable part of aging.
Your doctor will diagnose the type and cause of your incontinence based on your medical history, physical examination, and urine sample analysis results. Additionally, your doctor may request you keep a “bladder diary” for 1 week.
There is a huge variety of options available to treat incontinence. Your doctor will help you make an informed choice after diagnosing the specific type of incontinence you have and what is causing it.
Tips for Managing Urinary Incontinence
- Stop smoking. Nicotine is a known bladder irritant.
- Avoid irritating foods. Certain known foods and drinks can irritate the bladder and increase incontinence. Examples of irritating food include: coffee, tea, chocolate, soft drinks, citrus fruits and juices, tomato-based products, spicy foods, and alcohol
- Restrict fluids. Limit your fluid intake to roughly 64 ounces per day. Avoid going below that level as concentrated urine may also irritate your bladder.
- Lose Weight. Research has shown that for obese women, losing weight can help reduce incontinence by 60%.
- Keep Hygienic. Keep your genital area clean and avoid infections.
- Do Kegel Excercises. Kegel excercises are useful in training and strengthening the muscles around the pelvis.
- Electrical Stimulation. This is a painless therapy that helps retrain the pelvic floor muscles used in urination.
- Take Medications. There a wide variety of medication used to treat incontinence, depending on what type you have. Contact your healthcare professional to learn more.
- Get Surgery. There are many surgical techniques for complex problems and to correct anatomical defects. Contact your healthcare professional to learn more.
- Wear Pads. While the goal is to eliminate incontinence all together, it is advisable to wear special absorbent pads to provide better protection from accidents.