Urinary Symptoms
“Urinary incontinence is often improved with pelvic floor muscle exercises”
Urinary symptoms, including incontinence (persistent, involuntary leaking of urine), become more common with aging. Women are much more prone to the occasional episode of urine leakage than men. These symptoms may be partially affected by menopause.
As menopause approaches and 
during the years that follow, lack of estrogen can cause thinning of the lining of the urethra, the outlet for the bladder. With aging, the surrounding pelvic muscles may weaken. As a result, women are at increased risk for urinary incontinence.
The two most common types of urinary incontinence in women are stress incontinence and overactive bladder. Stress incontinence is caused by weak pelvic floor muscles. The most common symptoms are leakage of urine after coughing, laughing, sneezing, or lifting objects.
Overactive bladder is caused by bladder muscles that are overly active or irritated. The most common symptoms are frequent sudden urges to go to the toilet with occasional leakage of urine. Mixed incontinence is when stress incontinence. And overactive bladder occur simultaneously.
Causes & Risk Factors
Stress incontinence is most common during perimenopause and typically does not worsen with age, but the incidence of overactive bladder increases with the number of years after menopause.
In addition to aging and possibly decreased levels of estrogen, other factors contributing to urinary incontinence are the following:
-
Very high volume of fluid intake or drinking late at night—or over-restricting fluid intake
-
Being significantly overweight
-
Irritation of the bladder from smoking or consuming certain liquids (such as citrus juices or caffeine)
-
Certain prescription medications, such as diuretics and some tranquilizers
-
Infections of the bladder or urethra
-
Weakening of the pelvic muscle, nerves, and ligaments due to natural aging or previous damage from childbirth, particularly deliveries requiring use of forceps
-
Other medical conditions, such as stroke, diabetes, and the nerve disorder multiple sclerosis
- Very high volume of fluid intake or drinking late at night—or over-restricting fluid intake
Urinary Incontinence Treatment
Today, there are many strategies to treat urinary incontinence, and more are in development.
- Ask for Specialist Consult. The best option depends on the type and cause(s) of incontinence, the impact of incontinence on quality of life, and a woman’s general health. An effective approach teams the woman with a physician and a continence educator for coaching and support. When urinary incontinence does not improve with initial treatment, a physician with expertise in female urology or urogynecology should be consulted. A specialist is also recommended when there is a complicating condition, such as a neurologic disease, or when surgery is being considered. As many methods of incontinence treatment take time to be effective, it’s a good idea to use some form of protection against leakage.
Helpful Products. While menstrual pads work well for mild cases of incontinence, these products are designed to absorb blood and not urine. Their liquid holding capacity is, therefore, quite low, and very often they will overfill easily and may also give rise to skin irritation. A better solution is to use absorbent pad products specifically designed for urinary incontinence. However, always remember that the goal is not to rely on these products, but instead to seek a solution that will cure the problem. - Drugs for Stress incontinence. No medications are government approved for treating stress incontinence, and although various prescription drugs are sometimes used, none is particularly successful. Most of the drugs are designed to increase the resistance to outflow of urine from the bladder, often by strengthening the muscles that control urine flow. Side effects prohibit their widespread use.
- Estrogen. Although estrogen loss at menopause may increase the risk of stress incontinence, studies show no benefit from estrogen therapy. In fact, some research indicates that estrogen therapy may increase the risk.
-
Kegel Exercise. This type of urinary incontinence is often improved with pelvic floor muscle exercises (Kegel exercises). These involve repeated contraction and relaxation of the muscles which control urine flow, strengthening them so they can better support the bladder. Initially, the exercises may be done while urinating to see if the contractions can stop urine flow. When the correct muscles have been identified, the exercises should not be done while urinating because it may result in retention of urine. The muscles are contracted to a count of three and then relaxed. Recommended frequency is 10 exercises, five times each day. Kegel exercises can
produce a cure in more than 50% of women with stress incontinence, but they must be performed regularly to be effective. - Other Drugs. Several government approved prescription therapies are available to treat overactive bladder, including drugs that target the receptors of the bladder to reduce contractions and wetting accidents, and drugs that can help relax muscles so the bladder can empty more effectively.
A healthcare provider can help each woman choose the most appropriate option, typically based on side effects. As with stress incontinence, although lowered estrogen levels at menopause may increase the risk of overactive bladder, estrogen therapy has not been found to provide relief.
A healthcare provider can help each woman choose the most appropriate option, typically based on side effects. As with stress incontinence, although lowered estrogen levels at menopause may increase the risk of overactive bladder, estrogen therapy has not been found to provide relief.
………………………………………………………………………………………………………………
✿ How to Keep a Bladder Diary
Each day for a week, record the following:
- Type and amount of fluid intake and time of day
- Amount of urine voided and time of day
- Any urge that was sensed before voiding
- Amount of urine leaked, whether it was just a few drops or enough to wet underwear or soak clothing time of day and type of activity when the leakage occurred
………………………………………………………………………………………………………………
Comments on this entry are closed.