Bladder Problems in Older Women

Older women commonly experience bladder problems associated with pregnancy, hormonal changes during menopause, and the weakening of muscles associated with the aging process. Infection can cause bladder problems either for the duration of the infection, or by causing damage that needs medical treatment beyond the treatment of the infection.

Dysuria

• Dysuria is painful urination, usually a burning sensation. It may be caused by several other conditions. Urinary tract infection is the presence of bacteria in the urinary tract. When the urethra and bladder are infected, it can result in pelvic pain and painful urination. Vaginal yeast infection causes irritation in the vagina, which causes a burning sensation during urination. Interstitial cystitis is the inflammation of the bladder wall. This can also lead to dysuria.

Incontinence

• Incontinence is a common condition in older women. Stress incontinence is the leakage of urine from the bladder when pressure is exerted on the pelvis. This occurs during coughing, sneezing or strenuous activity. Urge incontinence is characterized by bladder muscle contractions that create the need to urinate, immediately. Urine is lost before one can find the opportunity to empty the bladder. Urinary incontinence can be caused by pregnancy and childbirth, hysterectomy and obesity. It can also be associated with urinary tract infections and other illnesses, including diabetes and cardiovascular disease.

Interstitial Cystitis

• Interstitial cystitis is most common in middle-aged women. It is not an infection. Most commonly, bladder pain associated with interstitial cystitis is not constant. It may go away for several weeks or months. Interstitial cystitis is characterized by the frequent, urgent need to urinate and incontinence. Bladder pain is often present when the bladder is filling or emptying. Treatment for interstitial cystitis may vary. Medications, nerve stimulation, lifestyle changes and pelvic muscle exercises are used to treat interstitial cystitis.

Prolapse

• Prolapse is the inability of the pelvic muscles to properly support the bladder. This is also called cystocele. Childbirth may damage or stretch the muscles. The drop in estrogen caused by menopause and the aging process contribute to the weakening of the supporting pelvic muscles. Bladder prolapse causes a heavy feeling, or pressure, in the pelvis. It can be treated by using exercises to strengthen the pelvic floor muscles, supporting the bladder with a vaginal insert called a pessary, or surgically repairing the bladder.

Urinary Tract Infection

• Urinary tract infections may become more common in postmenopausal women due to tissue changes around the vagina and urethra. Bacteria from the skin and anus may enter the urethra and bladder, which are normally sterile. Bladder infections can cause pelvic pain, the frequent and urgent need to urinate, and dysuria. In severe cases, blood may be present in the urine. Recurrent urinary tract infections may contribute to chronic incontinence.