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7 Strategies for Coping with Urinary Symptoms During Menopause

Dr. Jehan Ar

Why does menopause cause incontinence?

Just like other body systems, the urinary system is majorly affected in a menopausal lady. The genitourinary syndrome of menopause is a term coined to describe the effects of low estrogen levels on the pelvic floor, genital organs, bladder and urethra. The hypoestrogenic state causes thinning, loss of elasticity and reduced blood flow to mucosal surfaces of the bladder and vagina. The pelvic floor muscles weaken and the vagina loses its tone leading to prolapse of pelvic organs like bladder and urethra.

Symptoms of low estrogen bladder

  • Increased frequency of urination
  • Urgency of urination
  • Incontinence i.e. inability to hold urine
  • Recurrent urinary tract infections
  • Painful micturition
  • Feeling of incomplete bladder emptying

 What are 4 types of urinary incontinence?

●     stress incontinence

Involuntary leakage of urine during coughing, sneezing, laughing, lifting heavy objects or exercise.

●     urge incontinence

Feeling a strong sudden urge to urinate and inability to hold it till reaching the washroom.

●     functional incontinence

Inability to hold urine due to physical disabilities like arthritis causing a delay in reaching a washroom

●     overflow incontinence

Urinary leaking or dribbling because of the bladder being full and overflowing. This occurs when one is unable to empty the bladder fully while peeing and is common in diabetic patients.

Strategies to cope with menopausal urinary symptoms

1.   Lifestyle modification

Concentrated and acidic urine can irritate the bladder. Drink adequate water to keep urine diluted and avoid bladder irritants. This includes alcohol, foods, and beverages with high acid or caffeine content. Quit smoking as it causes chronic cough and can lead to a worsening of stress incontinence. 

Work outt regularly and maintain optimum weight to help ease pressure on pelvic organs. Wear protective and absorbent underpads to catch any leaks and avoid embarrassing episodes.

2.   Changing urinary habits

Some simple behavioral modifications are quite helpful in easing symptoms. Scheduled voiding or emptying your bladder before exercise or sex can reduce stress incontinence episodes. Gradual bladder training by resisting the urge to void helps increase the intervals between urination and is useful in treating an overactive bladder. Maintaining a bladder diary is important for you and your doctor in assessing how your bladder behaves and monitoring the effects of various therapies.
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3.   Physical therapy

Pelvic floor rehabilitation helps with bothersome urinary symptoms and is best done with kegel exercises. When done persistently, they gradually build the pelvic muscles' strength and reinforce bladder control. Your doctor may also advise vaginal weight training with small weights being held in the vagina by tightening vaginal muscles. The ensuing vaginal strength supports the bladder neck and urethra and improves stress urinary incontinence.

4.   Maintaining good vaginal health

Vulvovaginal atrophy associated with menopause has significant effects on the urinary system due to their closer association. Maintaining optimum vaginal health is important. This includes using vaginal lubricants and moisturizers as well as hormone replacement therapies when prescribed by your doctor. Recently, treatment with energy-based devices for anatomical remodeling of vaginal tissue is gaining popularity due to its efficacy. Experts in FemiLift, a laser vaginal rejuvenation treatment, are giving remarkable results in easing symptoms of urinary incontinence in menopausal women.

5.   Hormone replacement therapy

Hormonal health is one key aspect of a smoother menopausal journey. The low estrogen levels cause atrophy of the urogenital system. Vaginal estrogen formulations improve the symptoms of urgency and frequency of urine along with improvement in vaginal dryness and inflammation. The vaginal estrogen has the benefit of low systemic side effects as compared to oral estrogen formulations.

6.   Seeking professional advice

Seek professional advice from your doctor to determine the treatment best suited for you according to your symptoms and overall health. Convey your expectations from treatment and get informed about the limitations of various treatment modalities. Medical treatments can range from medicines for urgency to office procedures like bladder botox injections and surgeries for bladder and urethral support. A knowledgeable doctor can help you choose the best coping strategies and treatments for you.

7.   Joining support groups

Join online or local support groups of women going through the same phase of life and experiencing the same issues. Support groups are a great place to get innovative ideas about coping strategies and guidance about which doctors to choose.

Final thoughts

Urinary symptoms of menopause are a debilitating issue with a huge negative impact on quality of life. The root cause is hypoestrogenism, leading to a range of urinary tract problems. Getting the right diagnosis is key to its successful management. Due to the closer association with the genital system, a holistic approach to coping and management strategies is essential. A positive outlook and persistence help in substantial symptomatic improvement and the ability to get along with this unwanted and unwelcome annoyance.


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About the Author

Dr. Jehan Ara is a highly qualified consultant obstetrician and gynaecologist with a passion for writing and health education. She has more than 10 years of practical patient care experience. She is currently working as an Assistant Professor of Obstetrics and Gynaecology in a medical school and a clinical supervisor for post graduate residents of obstetrics and gynaecology in the affiliated teaching hospital. In addition to her clinical work, Dr. Jehan is also a passionate writer and educator. She regularly writes articles and blog posts on women's health. She is committed to helping women understand their bodies and make informed decisions about their health.


NOTE: The views expressed in this article are those of the author and do not necessarily represent or reflect the views of Nannocare. Nannocare is not affiliated, associated, authorized, endorsed by, or in any way officially connected with the author of this article, or any of its subsidiaries or its affiliates. 

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