Managing Incontinence During Menopause
Uh-oh. You know that feeling. You’ve just sneezed, coughed or cackled with laughter or picked up a heavy bag and now there’s a warm sensation in your underwear which tells you your bladder control has failed you again.
Incontinence is one of those things which many women seem to accept as a rite of passage, an uncomfortable and embarrassing inevitability of getting older.
You might joke about it with your friends but the reality of worrying about feeling clean and fresh can cause real distress as the odd accident turns into regular leakage.
There really is no reason to be embarrassed about leakage. Many people think urinary incontinence is only an issue for the heavily pregnant or old and infirm but in fact 30-70 per cent of women in peri-menopause and menopause suffer from some form of urinary incontinence. Ladies – you are not alone!
So are you finding that you bypass the sanitary product aisle and instead have started tucking packets of incontinence pads under your groceries instead of sanitary pads and tampons?
Don’t just accept incontinence (and pads) as the new norm – there are different ways of treating or coping with different types of incontinence and it might be helpful to firstly identify what might be the main cause of your incontinence and learn what you can do to improve the situation.
Stress Incontinence
This is the type most women suffer from during pregnancy. When I was pregnant my friend made me laugh like a hyena. I had to beg her to stop and do that little girl thing of holding myself to stop myself from peeing.
Many types of physical activity can cause leakage with this kind of incontinence – laughing, coughing, sneezing, lifting, jumping, running or even just bending over can result in damp panties.
This is the reason midwives and OBGyns constantly remind us to do our pelvic floor/Kegel exercises, as stress incontinence is caused by weakened pelvic floor muscles.
It’s never too late to start the exercises . They are not only good for improving bladder control but also for helping minor prolapses which are also common during menopause (can you tell I’m speaking from experience?).
Bear in mind it can take up to three months to see results from this kind of internal work out.
If you have never been able to master the “elevator going up" technique of exercising your vaginal muscles you could ask your healthcare provider to teach you or talk to you about Kegel exercise gadgets which you insert like a tampon and can make exercising easier.
Urgency Incontinence
As the name suggests, causes an overwhelming and frequent urge to urinate and is usually caused by an overactive bladder.
It’s particularly common in women who have had C-sections, are obese, have diabetes or who have suffered a stroke or nerve damage.
Kegel exercises might help, but medication or surgery is also an option- go and talk to your doctor if this affects you.
Another little-known cause of urinary incontinence is down to loss of oestrogen which of course is usually down to the menopause.
Like vaginal tissue, the muscles around the bladder and urethra (the tube which allows urine to pass from the bladder to the outside!) needs oestrogen to stay strong and supple.
Diminishing oestrogen during peri-menopause and menopause can cause muscles to lose strength, and bladder control to fail. Again, internal Kegel exercises might help, or your doctor might prescribe topical oestrogen maybe in the form of a small pessary to be inserted into the vagina.
It might be that your incontinence is caused by more than one of these (or other) types of urinary incontinence. You might only have problems at night when you find yourself getting up in the small hours for a bathroom break.
At Home Treatment
There are things you can try at home if your incontinence is minor or infrequent.
Firstly try cutting down on the amount of alcohol or caffeinated drinks you drink as they act as a diuretic. Coffee is the worst culprit but it’s also worth looking at the amount of tea, fizzy drinks or even hot chocolate you consume too.
If you find you pee when you lift, avoid lifting! Or consciously tighten your vaginal muscles as you lift (heavy grocery bags for instance) which will help to prevent leaks.
Try losing weight – it’s not only your bladder which will benefit, especially if you are significantly overweight. Chat to your healthcare provider for advice and support.
This might seem like odd advice, especially if you have to get up in the night to pee but try drinking more water. Yes MORE water. This will help to increase bladder capacity and allow longer gaps between toilet trips.
Did you know that what you eat could exacerbate incontinence? Avoid spicy or citrusy foods as they can irritate the bladder.
Treat constipation quickly as straining to empty your bowels can weaken bladder muscles. Make sure you eat plenty of fibre, drink lots of water and take some exercise every day to help bowel transit.
If constipation persists consult a doctor. There maybe short-term medications to help or it might be that you actually aren’t sitting correctly on the toilet or aren’t using your muscles in the right way.
Conclusion
Hopefully the message you will get from this article is that you don’t have to suffer in silence and soggy undies – there are lots of ways to sort out urinary incontinence whatever the cause.