Menopause & Incontinence

There is a good reason that menopause is called the "change of life." With the end of menstruation, comes a host of other changes triggered by the end of estrogen production by the ovaries. One of the more worrisome of those changes is urinary incontinence, which is experienced by roughly 40 percent of postmenopausal women, according to Nancy Sullivan, manager of Providence Continence Center in Portland, Oregon.

Leakage

• The loss of bladder control with the onset of menopause is characterized by problems of leakage that can be set off by something as innocuous as a sneeze, cough or even laughter. According to a booklet, Menopause and Bladder Control, published by the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), lifting also can trigger an episode of urinary incontinence. This type of urine leakage is called stress incontinence.

Cause

• Many medical researchers believe that the sudden drop in estrogen levels contributes to a weakening of the muscles that are used in bladder control. They suggest that the female sex hormone "may help keep the lining of the bladder and urethra plump and healthy," according to the NKUDIC booklet. For those who think that the problem can be solved by taking hormone replacement therapy, the news is disappointing, as science can find no evidence that such supplements in any way improve bladder control. And, as other studies have concluded, there are multiple risks associated with the long-term use of such supplements.

Other Factors

• Although the menopausal weakening of the bladder and urethra muscles is a major factor in urinary incontinence, other factors can play a contributing role in this potentially embarrassing problem. According to the NKUDIC booklet, these include urinary infections, certain medications, difficulty walking or moving, cardiac problems, feelings of depression and nerve damage caused by stroke or diabetes.

What Can Be Done

• If you're experiencing problems with urinary incontinence, discuss the problem with your family doctor, gynecologist or urologist. Measures that have proved helpful in some women include a sharp reduction in caffeine consumption, regular exercise of the pelvic muscles and training the bladder to hold more urine. Your doctors may also order some of the following procedures to help resolve the problem: insertion of a device into the vagina to provide bladder support, surgery to reposition and strengthen the bladder, biofeedback, insertion of a device into the urethra to prevent leakage and electrical stimulation of the pelvic muscles.

Pelvic Floor Exercises

• Sullivan, who manages Portland's Providence Incontinence Center, is a big advocate of pelvic floor exercises, also known as Kegels. She explains that the pelvic floor provides support for the organs of the pelvis, which include the bladder. When these muscles weaken, urinary incontinence is likely to follow. Kegels may be familiar to women who were introduced to them during pregnancy. Kegel exercises work the muscles used to control the flow of urine. To work them out, simply practice stopping and starting the flow of urine when using the bathroom and this will give you an idea of what to do when you want to work them out at any other point of the day.