"Lately when I sneeze, cough, or laugh I find that I
wet my pants. This is so embarrassing! I have noticed that I’m in the bathroom more
than I’m not! I’m worried I’ll be in Depends before my 45th birthday next
March. My doctor said something about this being a normal part of perimenopause and
menopause. It doesn’t feel normal for me."
Stress
Incontinence
You are describing stress incontinence. This loss of urine
occurs when a woman exerts some light pressure as with laughing, sneezing and/or coughing.
This is a very common problem in perimenopause/menopause and as we age. In fact 56 percent
of perimenopausal women have this symptom. It decreases to 41 percent after menopause. It
also sounds like you have bit of urge incontinence.
Urge Incontinence
Urge incontinence is heralded by the sudden, strong urge to
urinate. This powerful need to urinate occurs acutely and without warning. With urge
incontinence innocent activities like running water or washing hands can set off a
woman’s bladder. If you are experiencing urinary problems first rule out any other
cause before you blame perimenopause. Make sure the frequent urination is not a sign of
diabetes or other illnesses. Talk with your doctor or health care provider about these
bladder changes
There are a
number of causes
of stress and urge incontinence.
The loss of estrogen during
perimenopause/menopause weakens the lining of the bladder, urethra, and vagina leaving
them more susceptible to injury and inflammation. The walls of the urethra and bladder
rely on estrogen as one way to stay toned and able to manage the flow of urine. With less
estrogen these organs have a harder time staying fit. When we lose estrogen our lower
urinary tract, like the vagina, loses elasticity, support, and some degree of function.
Our sacral nerve which controls the pelvis and its organs is full of estrogen receptors. A
change in hormone levels may affect the excitability of the nerves and make you feel like
you have to urinate more frequently. This may explain why women find themselves with
bladder problems at this time of their lives.  According to the book, the pause by Lonnie Barbach, "The Pause"
some women may have a loss of urine during sexual intercourse and orgasm. This can be very
upsetting but please note there are many women who have this problem.
Perimenopause is
characterized by fluctuations in our hormone levels, especially estrogen and progesterone.
High levels of progesterone can cause frequent urination as progesterone acts like a
diuretic. This may be the reason for frequent urination during the second half of our
cycles.
In addition, low estrogen levels cause vaginal secretions
to become less acid and more alkaline, creating an environment more friendly to harmful
bacteria. This mean that urinary tract infections (UTIs) caused by harmful bacteria are
more common during perimenopause and menopause. Women who rarely or never have UTIs in the
past find themselves having one every few months.
How many trips to
the bathroom
do you make during the night?
It is not uncommon for both MEN and women to
be in and out of the bathroom during sleeping hours. Voiding at night ( nocturia) occurs
not because of lowered estrogen levels. The normal pooling of blood in our lower body
during the day is the main culprit. Once we go to sleep and have our feet up the fluid is
reabsorbed into our bloodstream, filtered by our kidneys, and flows into our bladder which
stretches and contracts. The stretching and contractions signals our brains to wake up and
go to the bathroom.
What
can be done about incontinence?
Kegel exercises: These exercises work to
strengthen the pubococcygeus muscle (PC) which is the band of muscle that extends from the
pubic bone in front to the tailbone in our back. Since this muscle’s job is to
support the vaginal tissues and the internal pelvic organs it requires continual
strengthening like any to other muscle.
Here’s how
to do Kegel Exercises :
If you are not sure where the PC muscle is
located, the next time you go to the bathroom, try and stop the flow of urine. The muscles
you contract are the PC muscles. Don’t strain or push when doing these exercises.
Breath regularly. Kegel exercises can be done anywhere at any time. No one will know that
you are doing them.
- Tighten your PC muscle tightly for the count of three, then
relax the muscle for the count of three. Relaxing the muscle is just as important as
tightening. Repeat this and then slowly build up to last ten seconds per tightening and
relaxation.
- Tighten and release the PC muscle for a repetition of 10
squeezes and relaxations. Start out by doing this five times a day, at different parts of
the day and then gradually increase the repetition to 15-20 per session. Kegel exercises
help reduce stress incontinence in 50 - 90 percent of women with this type of bladder
problem. They also help to enhance sexual intercourse.
Time Beverages:
Try to time your beverages (this includes
water too) so that you are not drinking too much at one part of the day. Limit cafeineated
beverages. Caffeine works as a natural diuretic and can also stimulate the bladder to
empty. No beverages before bedtime.
Talk with your
doctor
about this problem to make sure the problem
isn’t caused by something other than perimenopause/menopause. There are medications
to help control incontinence.
- To prevent urine loss during intercourse and UTI's empty your bladder before and after
intercourse.
- Drink one 8 ounce glass of pure cranberry
juice (not cocktail) to prevent UTIs. The tannins in the cranberries prevent
bacteria in the urine from sticking to the bladder wall and causing an infection.
Blueberries also contain tannins.
Menopause & Incontinence
  Urinary incontinence is embarrassing and many women do
not want to talk about it, yet suffer in silence. Larrian Gillespie, author of: "You
Don't Have to Live with Cystitis" says, "Because the pharmaceutical industry
recognized that the biggest users of oversize Kotex were incontinent women, a new market
has evolved, which always means newer or better products in direct proportion to
sales." Find out what you can do to help yourself to stop the silent suffering with
these great tips and ideas from Dr. Gillespie.
ABC's of UTI's
 Urinary tract infections (UTIs) are
a common occurrence for women. Women tend to get more UTIs than men because of their
shorter urinary urethras this is where the urine passes when voiding) and changing
chemical balances within their urinary and reproductive systems. Burning when urinating,
frequent urination, strong smelling or foul smelling urine with low abdominal pain are
usually the hallmarks of a UTI. How can you prevent getting one? |
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