Menopause and Overactive Bladder: Yes, They’re Connected
Do you plan your day to make sure bathroom stops will be available at short notice and scope out buildings so you always know where the nearest bathroom is? Do you tell yourself to wait an hour for that glass of iced tea so you won’t have to dash for the ladies’? If so, it’s likely you have a condition called overactive bladder, or OAB. And if you’re between 40 and 55, you may be one of the many women for whom OAB is a menopause- and age-related problem.
One comfort: You’re in good company. Studies show overactive bladder affects at least — and probably more than — 17 percent of women in the U.S. Why more? Because this problem is vastly underreported, due to the embarrassment factor. (It’s not the easiest thing to talk to your doctor about.) But help is available. In the meantime, here’s what you should know about the connection between OAB and menopause — along with available treatments.
What’s the connection between menopause and OAB?
During perimenopause, the period leading up to menopause, and menopause itself, the level of estrogen — which helps to keep the tissues of your bladder and urethra healthy — begins to drop significantly. If you’ve begun to notice dryness and sensitivity during sex, it’s likely you’re at risk for bladder problems as well. The reason: Just as the tissues of the vaginal wall begin to thin and dry out, so does the tissue that lines the bladder. When that happens, your bladder becomes more sensitive to irritants and more susceptible to «hair-trigger» releases.
What’s more, lack of estrogen can cause the pelvic muscles, which are responsible for maintaining bladder control, to weaken, eventually resulting in incontinence.
What kinds of bladder control problems can happen with menopause?
Overactive bladder problems take several forms:
Urgency: When you have to go, you have to go now.
Frequency: You have to go all the time, defined as a problem if you need to go more than eight times in a 24-hour period. And yes, this problem is a doozy for sleep disruption.
Urge incontinence: The need to go now comes on suddenly, and if life conspires to keep you from a bathroom, you’re likely to have an accident.
How is overactive bladder diagnosed?
To diagnose a bladder control problem, your doctor will perform a physical exam, including a pelvic exam, and order lab tests to look for signs of a urinary tract infection or other problems. The doctor will likely ask you to keep a «voiding diary» in which you write down when you go, note any associated symptoms, and describe accidents or other problems. Keeping a diary can also help you reconstruct the circumstances prior to an accident (what you ate and drank beforehand, for example) or any overwhelming urges you can recall.
What treatments are available for menopause-related overactive bladder?
There are treatments for overactive bladder that help you control urges, treatments that strengthen muscles or improve muscle control, and treatments aimed to reduce irritation. Your primary care physician or a specialist can work with you to analyze the type of bladder problems you’re having and devise the best treatment plan. Doctors are likely to suggest lifestyle changes, muscle-strengthening exercises, and bladder retraining before they start considering medications — which might have side effects — or surgery. What follows are the most common treatment strategies for bladder problems associated with menopause, in the approximate order a doctor might suggest them.
Treatments for menopause-related OAB
Many women are surprised to learn how dramatically what they eat and drink can affect bladder function. With that in mind, try eliminating these foods and beverages — all known to irritate the bladder, triggering urges — one at a time:
coffee and black tea
citrus fruits and juices
regular and diet sodas
tomatoes and tomato-based foods and sauces
vinegar and vinegar-based salad dressings
To protect your bladder from irritation and urges:
Drink eight glasses of water, spaced throughout the day.
Drink milk, almond milk, or soy milk to see if this soothes the bladder.
Take a probiotic supplement, which helps control yeast growth and promotes a healthy bladder.
Strengthening bladder muscles with Kegel exercises, Bladder retraining for OAB; Estrogen therapy; Weight loss; Biofeedback and Sacral nerve stimulation surgery