You think the hot flashes are bad? Another common symptom of menopause is bladder control problems, also known as urinary incontinence.
During perimenopause and menopause, levels of estrogen in the body drop dramatically. Estrogen does things like control the menstrual cycle and body changes during pregnancy; this hormone also helps keep your bladder and urethra healthy. As your body goes through menopause and has less estrogen in action, the pelvic muscles that control your bladder can get weaker.
There are different types of bladder control problems that can develop during and after menopause. Perhaps the most common kind of bladder control problem is stress incontinence — leakage thanks to pressure from coughing, sneezing, or lifting. Urge incontinence is another common type of bladder control problem; the bladder muscles squeeze at the wrong time, leading to leakage. Many women also have trouble with nocturia — waking up (and getting out of bed) several times a night to urinate.
In order to place the blame for bladder control problems on menopause, the doctor has to rule out other possible causes — like infections, nerve damage, and certain medications. You’ll need a pelvic exam and urine testing. Your doctor may also ask you to keep a diary of your bathroom habits to help recognize symptoms and situations that lead to problems.
The type of bladder control problem you have will largely determine the treatment. Your doctor may suggest certain lifestyle changes, like limiting caffeine and alcohol consumption, quitting smoking, and losing weight to help improve bladder control. Your doctor may also recommend Kegel exercises to help strengthen the muscles in your pelvis. There are medications and surgeries that can ease bladder control problems.
Your primary care doctor may suggest a specialist for your bladder control problems. A gynecologist specializes in women’s health care; a urogynecologist focuses specifically on women’s bladder problems. A urologist specializes in bladder problems. A physical therapist may be able to help you retrain weakening muscles in the pelvis. Any one of these doctors may be able to help you deal with menopause-related bladder control problems.