Menopause and Bladder Control

Menopause and Bladder Control
Source: NIH Publication No. 02-4186

Does menopause affect bladder control?
Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.
After your periods end, your body stops making the female hormone estrogen (ES-truh-jun). Estrogen controls how your body matures, your monthly periods, and body changes during pregnancy and breast-feeding.

Estrogen also helps keep the lining of the bladder and the urethra (yoo-REE-thrah) plump and healthy.

Lack of estrogen causes the bladder control muscles to get weak. Your doctor may give you medicine to replace estrogen to prevent future bladder control problems.

Be sure to tell your doctor if you or your family has a history of cancer. If you face a high risk of cancer of the uterus or breast, the doctor may not prescribe estrogen.

Pressure from coughing, sneezing, or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence. It is one of the most common kinds of bladder control problems in older women.

Good bladder control allows women to lead a fully active life.

What else causes bladder control problems in older women?
Sometimes bladder control problems are caused by other medical conditions. These problems include

nerve damage from diabetes or stroke
heart problems
feeling depressed
difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time–or all the time–and cause leaks.

If you have this problem, your health care team can help you retrain yourself to go to the toilet on a schedule.

What should you do about bladder control after menopause?
Talk to your health care team. You may have stress or urge incontinence, but other things could also be happening.
Medicines and exercises can restore bladder control in many cases. Your doctor will give you a checkup first.

Teaching your bladder a new routine can reduce urge incontinence.

What treatments can help you regain bladder control?
It depends on what kind of bladder control problem you have. Hormone medicines are only one treatment. Your health care team may also recommend some of the following:

limiting caffeine
exercising pelvic muscles
training the bladder to hold more urine
If these simple treatments do not work, your health care team may have you try something different. These treatments might include

electrical stimulation of pelvic muscles
a device inserted in the vagina to hold up the bladder
a device inserted directly into the urethra to block leakage
surgery to lift a sagging bladder into a better position
What professionals can help you with bladder control?
Professionals who can help you with bladder control include

your primary care doctor
a gynecologist (guy-nuh-CALL-uh-jist): a women’s doctor
a urogynecologist (YOOR-oh-guy-nuh-CALL-uh-jist): an expert in women’s bladder problems
a urologist (yoor-ALL-uh-jist): an expert in bladder problems
a nurse or nurse practitioner
a physical therapist

Points to Remember

Some women have bladder control problems after they stop having periods.
Replacing female hormones may prevent future bladder control problems.
Exercising pelvic muscles can help you maintain or improve bladder control.
Treatment depends on the type of bladder control problem(s) you have. Talk to your health care team to find the treatment that’s right for you.