URINARY INCONTINENCE DEFINITION
Urinary incontinence (UI) is the medical name for loss of bladder control or involuntary urinary leakage. It means that you pee unintentionally – how and when this happens depends on what type of urinary incontinence you have.
Stress incontinence – Pee leaks when your bladder is under pressure, such as when you cough, laugh, exercise or lift something heavy. You might experience a small leak or complete loss of control.
Urge/urgency incontinence – Also known as an overactive bladder, this is when pee leaks when you feel a sudden, often intense urge to pee. You may also feel a constant urge to pee, even when your bladder is empty.
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HOW LIKELY IS MENOPAUSE INCONTINENCE?
- It affects 30-40% of middle-aged/menopausal women, rising to 50% for postmenopausal women
- Women who have been pregnant are more likely to suffer from this than those who have not
- Your weight, alcohol and caffeine consumption and being on certain medications can also increase risk of suffering from urinary incontinence
- Having a urinary tract infection can also cause temporary urinary incontinence
Read more about the stages of menopause.
HOW TO COPE WITH INCONTINENCE IN MENOPAUSE
You may experience other menopause symptoms alongside incontinence, including vaginal prolapse or anxiety. There are short-term fixes but these aren’t sustainable long-term – we recommend talking to your doctor:
1 Do your research. If you are going out, make sure you know in advance where the nearest toilets are. Always make sure you have some change for the loo handy.
2 Research pads. You can buy from a supermarket super absorbent pads and knickers to manage leaks or to help you when exercising. Underwear has improved hugely in terms of style and function – you can find plenty of companies online that make attractive knickers that are also absorbent.
3. Protect your bed. Online you can buy mattress protectors and washable or disposable absorbent sheets. There are also hand-held urinals available and devices that can be placed into the vagina or urethra to prevent urine leakage.
TREATMENT FOR BLADDER WEAKNESS IN MENOPAUSE
Strengthen your pelvic floor
Doing daily pelvic floor exercises can really help improve menopause leaky bladder. Download Stella for a personalised pelvic floor plan.
Train your bladder
Plan your trips to the bathroom during the day to gradually increase the amount your bladder can hold.
Adjust your lifestyle
Limit caffeine and alcohol as they are diuretics, making you pee more. Drink the recommended amount of water and not too much.
Losing weight reduces the pressure on your bladder and pelvic floor region. Read more about why the fun police is on about your menopausal lifestyle.
Talk to your doctor about medication
Some women are suffering so much from urgency, going to the toilet many times and are uncomfortable with the feeling of always needing to pee. Thankfully there are medications – typically, antimuscarinic drugs, which are bladder relaxants. These can provide some relief and help support you while doing pelvic floor strengthening and bladder training.
SURGICAL PROCEDURES FOR URGE INCONTINENCE
Your GP may refer you to an urogynaecologist to discuss possible surgical options:
- Botulinum Toxin A injections: Botox is injected into the walls (muscle) of your bladder, and acts to paralyse the muscle so it is less overactive. The effects can last several months and you can have repeat injections if needed.
- Sacral nerve stimulation / posterior tibial nerve stimulation: The bladder muscle is controlled by passing an electrical current through the nerves that control the bladder.
If you still suffer terribly from urge incontinence and the above treatments have not worked, there are some other procedures available. However, these are far less common, as most people do improve with the options above.
SURGICAL PROCEDURES FOR STRESS INCONTINENCE
For stress incontinence, the main treatment is activating and strengthening your pelvic floor. Typically you would do this with a women’s health physiotherapist. If you are still suffering, you may be referred to a urogynaecologist to discuss surgical procedures which may help:
- Colposuspension: The neck of the bladder is lifted up and sewn into its new position, preventing leakage long-term.
- Sling surgery: A sling made from human or animal tissue is placed around the neck of your bladder to support it.
- Urethral bulking agents: This is injected into your urethra’s walls to increase size and allow the urethra to close with more force.
INCONTINENCE AND MENOPAUSE
The fear of going somewhere new where you do not know where the loos are can be overwhelming”
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