Bladder Problems At Menopause

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Dr. Manu Lakshmi

30 Aug 2022

Bladder Problems

Bladder problems are important social issues that affect more than 50% of women at menopause. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression. The time of menopausal transition is often marked by hormonal changes that affect the health of a woman. Scientific reports indicate that onset of menopause is marked by many unpleasant symptoms that worsen the quality of life of many women even before climacteric. Bowel problems negatively affect various aspects of life, significantly reducing the quality of activities associated with work, physical involvement or the intimate sphere. Unlike what many women think of bowel problems as an inevitable part of the ageing process, there are ways of Menopause Treatment in Chennai to prevent and treat bowel conditions at menopause. 

Why do bladder problems occur at menopause?

Women at menopause face bladder control issues due to specific changes that include:

  • Vaginal tissue that become less elastic.
  • Thinning of the lining of urethra, the tube that empties urine from the bladder.
  • Weakening of pelvic floor, the group of muscles that supports both urethra and bladder.

These changes may be contributed by one or a combination of below factors:

  • Among the many important etiological factors of bladder disorders, genetic factor is the most common as it is higher in women whose ancestors suffered from bladder control problems. 
  • Age is also an important factor as the risk of bladder disorders increases in direct proportion to age, hence higher at menopause. 
  • Low levels of oestrogen in blood, along with occurrence of urinary tract infections, common around the time of menopause, create a situation that reduces the size of the urethra. Sometimes the urethra is shortened to 1-2 cm, very often followed by muscle weakness and relative adjustment of the bladder and the muscles responsible for the excretion of urine.
  • The next important factor is the number of pregnancies and particularly induced vaginal births. The probability of losing bladder control also increases when the foetus weighs heavy. 
  • Obesity is yet another factor that can be most dangerous. Studies show that obese women specially with abdominal obesity are 4-5 times more likely to suffer from bladder disorders than those of normal weight. 
  • Urinary tract infections, chronic constipation, diabetic neuropathy, Parkinson’s disease, multiple sclerosis and polyradiculopathy when ignored or improperly treated or use of drugs or medications like diuretics, antihypertensive and anxiolytic are also a group of factors that can affect the occurrence of bladder dysfunctions at menopause. 
  • Chronic respiratory diseases, particularly with persistent cough leading to increased abdominal pressure like in cases of chronic obstructive pulmonary disease are also found to be a factor in contributing to bladder problems at menopause.
  • Uterine fibroids is a common condition of the female reproductive tract and bladder symptoms are more prevalent in these women during menopause.

Common bladder problems at Menopause

The most common bladder problems that affect women during and after menopause, that require treatment by best gynaecologist in Chennai are:

  • Stress incontinence is the most common kind of bladder control problem in older women. This type of bladder problem is most often caused by physical changes that result from menopause. It is the inability of the weakened bladder muscles to hold back urine when there is pressure on the bladder, like cough, exercise, sneeze, laugh, or while lifting something heavy. Small leakage of urine or a complete loss of control can be the result of weakness.
  • Urge incontinence otherwise called the overactive or irritable bladder happens when bladder muscles squeeze incorrectly or lose the ability to relax, giving a feeling of the constant urge to urinate, even when the bladder is empty. The need to urinate often comes on fast and unexpectedly, not giving enough time to make it to the bathroom. 
  • A bladder with overflow incontinence does not empty fully, showing up as continuous urine dribbling. A weak urinary stream can create a feeling of frequent urinating at night. Nocturia is the urge to wake up several times to empty the bladder during the night. An increased urinary hesitancy also can be caused by underactivity of the bladder muscles. 

Treatment for bladder problems at menopause

Primary treatment for menopausal women with urogenital atrophy involves hormone therapy as lack of oestrogen is the main cause of bladder disorders. Hormone replacement can restore bladder to premenopausal condition and relieve many symptoms of urogenital atrophy. Hormones taken orally  as systemic hormone therapy affects the whole system and helps reduce the urinary symptoms of urgency, frequency, nocturia and painful urination. However, urogenital atrophy is better restored by local oestrogen, applied externally. This not only relieves the symptoms of bladder dysfunction buts also helps prevent urogenital atrophy and the recurrence of urinary tract infections. Low-dose vaginal oestrogen replacement, utilizing creams, tablets or vaginal rings are the most common treatment for vaginal atrophy symptoms causing bladder problems in menopausal women. Some women may not able to take hormonal therapy for any menopausal urinary symptoms like cases of women with breast cancer. Lifestyle changes and medical procedures form the non-hormonal treatments for bladder control symptoms, including those related to pelvic organ prolapse and weakening of the pelvic floor muscles. Lifestyle modifications in the treatment for bladder problems at menopause include:

  • Reducing caffeine 
  • Increasing the capacity to hold urine and control the timing of urination through bladder training techniques
  • Learning body function techniques with the help of biofeedback
  • Maintaining a healthy body weight
  • Carrying out relaxation techniques to avoid stress to the pelvic area 
  • Strengthening pelvic muscles by doing Kegel exercises
  • Electrical stimulation of the bladder muscles
  • In case of a prolapsed bladder, inserting a pessary device in the vagina can hold up the bladder
  • Leakage can be blocked by placing a device in the urethra
  • The prolapsed organ can be supported by restructuring, using various surgical techniques. Myomectomy in Chennai is used for fibroid debunking as a treatment for bladder problems in menopausal women.
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