"Menopause is a time of many hormonal and physical changes for a woman," says McLeod OB/GYN Dillon Gynecologist Dr. Melissa Brooks. "Some of these transitions, along with other risk factors, can lead to loss of urine and pelvic organ prolapse. Women may also have symptoms related to hormonal changes (dryness, irregular bleeding, hot flashes, night sweats, insomnia, mood changes, and slowed metabolism)." Many of these issues will improve with treatment.
Stress incontinence (loss of urine with coughing, laughing, sneezing, or physical activity) is the second most common cause of urine leakage in peri-menopausal women. This type of incontinence occurs when the muscles of the pelvic floor weaken, and may become more troublesome with hormonal changes. These muscles help to hold urine in the bladder, much like you can use two fingers to pinch a balloon to keep air from escaping. If these muscles are not strong enough to create a strong seal, leakage can occur when there is increased pressure on the bladder from coughing, laughing, and sneezing, among other physical activities. This type of incontinence is also the most common cause of urine leakage in younger women and can be due to pregnancy and childbirth stretching the muscles. Obesity, at any age, can also make this type of incontinence worse.
There are actions which may be taken to help with stress incontinence:
1) Try to maintain your weight. One of the natural results of aging is that the body doesn’t burn as many calories. A well-balanced diet with attention to portion size and regular exercise can help maintain weight. If you are trying to lose weight, even a small amount of weight loss can improve your symptoms.
2) Do Kegels as part of your workout routine. This is a simple exercise that helps to strengthen the pelvic muscles responsible for stopping urine flow and can greatly improve symptoms. Tighten these muscles and hold for 15 to 30 seconds, and then relax. Repeat this 10-15 times several times a day.
3) Watch what you drink. Caffeine in coffee and sodas, as well as carbonation, can irritate the bladder. Caffeine and alcohol will both cause an increase in the amount of urine your body makes.
4) Use a bladder diary to help keep track of symptoms. Write down what you are drinking, how often you urinate, how often leakage occurs, and what you are doing when it does occur.
5) Include fiber in your diet to aid digestion and avoid constipation. Straining to have a bowel movement can weaken the pelvic muscles over time and increases risk for incontinence and other issues.
For more information on menopause and other pelvic health issues, visit McLeodPelvicHealth.org.