November 13, 2019
Menopause and SUI
The human body is an incredible thing. We grow, change, and adapt so much over the course of our lives and we hardly consider how amazing it is. While all bodies are amazing, the female anatomy and functions are especially fascinating given the number of hormone changes that take place in the woman’s lifetime. One of these incredible changes comes after childbearing years - menopause. While most women associate “The Change” with hot flashes and mood swings, urinary incontinence can also develop as a result of the bodies changing hormones. It hardly seems fair, but the urinary tract and the female sex hormone, estrogen, are more closely related than most think.
To be specific in what kind of urinary incontinence we’re talking about (yes, there are several kinds) we’re discussing what is known as Stress Urinary Incontinence, or SUI. SUI is a fairly common problem for women with about one in four women over the age of 18 experiencing bladder leaks affecting an estimated 15 million adult women in the United States alone. Stress incontinence causes a leak whenever pressure or “stress” is put on the bladder, abdomen, or urinary tract. There is no feeling to “go” when this leak happens, it is a sudden accidental and involuntary loss of urine. SUI can be linked back to a weakened pelvic floor and/or the urethral sphincter not being strong enough to seal off effectively. So when the pressure is placed on the urinary tract or bladder, the muscles are simply not strong enough to hold back the flow. The pressure that can trigger these leaks can be from anything from coughing and laughing to doing yoga or picking up a child. There can be several reasons that women develop light bladder leaks and just one cause can be hard to pinpoint. The pelvic floor can be weakened or damaged and lead to leaks in the following ways:
Beyond general muscle loss and weakening as we age, another natural reason that women may develop leaks is due to menopause. Menopause can be described as a point in time 12 months after a woman's last period. Before this period in time, women go through what is called perimenopause. That’s when all of those super fun symptoms like hot flashes and mood swings come about. During this time, the ovaries produce less estrogen and progesterone (the human sex hormones) gradually over time. Perimenopause and transitional symptoms usually start around the ages of 45 to 55 in a woman’s life. The full transition usually takes about 7 years but can last up to 14 years. After menopause, a woman is no longer able to get pregnant and she no longer has a menstrual cycle. If you’re experiencing the following symptoms, you may be going through or starting to go through “The Change”, as symptoms can start to show several years before the last period:
How is this transitional stage in a woman’s life related to light bladder leaks? Well, estrogen, one of the hormones produced by the ovaries that slows in production during perimenopause, is actually pretty involved in the urinary tract and function. Turns out that estrogen is used by our bodies to line the urethra and the bladder, and when there is a lack of the hormone, those parts become weaker which could lead to leaks. There have been studies that have implicated estrogen deficiency in the aetiology of lower urinary tract symptoms with 70% of women relating the onset of urinary incontinence to their final menstrual period. As if weight gain, hot flashes, and night sweats weren’t enough, women may also get to experience light bladder leaks as a result of menopause!
What is Stress Urinary Incontinence?
To be specific in what kind of urinary incontinence we’re talking about (yes, there are several kinds) we’re discussing what is known as Stress Urinary Incontinence, or SUI. SUI is a fairly common problem for women with about one in four women over the age of 18 experiencing bladder leaks affecting an estimated 15 million adult women in the United States alone. Stress incontinence causes a leak whenever pressure or “stress” is put on the bladder, abdomen, or urinary tract. There is no feeling to “go” when this leak happens, it is a sudden accidental and involuntary loss of urine. SUI can be linked back to a weakened pelvic floor and/or the urethral sphincter not being strong enough to seal off effectively. So when the pressure is placed on the urinary tract or bladder, the muscles are simply not strong enough to hold back the flow. The pressure that can trigger these leaks can be from anything from coughing and laughing to doing yoga or picking up a child. There can be several reasons that women develop light bladder leaks and just one cause can be hard to pinpoint. The pelvic floor can be weakened or damaged and lead to leaks in the following ways:
- Childbirth
- Smoking & chronic coughing
- High-impact activities like dancing, running, or horseback riding
- Being overweight or obese
- Pelvic cancers - cervical, uterine, bladder, etc.
- Surgical procedures that involve the pelvic area like a hysterectomy
What is Menopause?
Beyond general muscle loss and weakening as we age, another natural reason that women may develop leaks is due to menopause. Menopause can be described as a point in time 12 months after a woman's last period. Before this period in time, women go through what is called perimenopause. That’s when all of those super fun symptoms like hot flashes and mood swings come about. During this time, the ovaries produce less estrogen and progesterone (the human sex hormones) gradually over time. Perimenopause and transitional symptoms usually start around the ages of 45 to 55 in a woman’s life. The full transition usually takes about 7 years but can last up to 14 years. After menopause, a woman is no longer able to get pregnant and she no longer has a menstrual cycle. If you’re experiencing the following symptoms, you may be going through or starting to go through “The Change”, as symptoms can start to show several years before the last period:
- Irregular periods
- Vaginal dryness
- Hot flashes
- Chills
- Night sweats
- Sleep problems
- Mood changes
- Weight gain and slowed metabolism
- Thinning hair and dry skin
- Loss of breast fullness
How Menopause Impacts Urinary Health
How is this transitional stage in a woman’s life related to light bladder leaks? Well, estrogen, one of the hormones produced by the ovaries that slows in production during perimenopause, is actually pretty involved in the urinary tract and function. Turns out that estrogen is used by our bodies to line the urethra and the bladder, and when there is a lack of the hormone, those parts become weaker which could lead to leaks. There have been studies that have implicated estrogen deficiency in the aetiology of lower urinary tract symptoms with 70% of women relating the onset of urinary incontinence to their final menstrual period. As if weight gain, hot flashes, and night sweats weren’t enough, women may also get to experience light bladder leaks as a result of menopause!
Solutions
Because SUI is so common, especially for women, there are plenty of solutions available for light bladder leaks, just take a look down the feminine hygiene aisle. While menstrual pads and incontinence pads are made out of different materials, they’re both applied and used the same way. To avoid infection, odor, or irritation these pads and liners have to be changed periodically. While some women enjoy using pads, others feel like they’re wearing menstrual pads even years after their last regular period. Your doctor may prescribe estrogen cream or ointment to help reline the urethra and bladder. While this may be a great option for women who are experiencing leaks as a result of hormonal changes, it may not be an option for younger women. Another solution for women of all ages and periods in life experiencing leaks is a reusable bladder support device called Revive®. Revive® is inserted like a tampon to support the bladder internally for up to 12 hours a day. Made in one comfortable size for all women to buy over-the-counter. After using, the device is easy to remove, clean, and store in the provided carrying case for the next use. Find Revive® at retailers nationwide.