Bladder Urgency

Bladder Urgency During Menopause

Are You Making a Lot More Trips to the Bathroom Lately?

When our body changes, it can be very confusing and upsetting, especially when those changes involve experiencing an overactive bladder and incontinence. Bladder issues can affect both men and women and can occur at any age. Experiencing leakage and urgency disrupts your daily routine, favorite activities, intimacy with your partner, and even sleep.

Often, though, most cases of overactive bladder go undiagnosed and untreated. Why? One of the biggest reasons is that patients are extremely embarrassed about their condition and believe that no treatment options are available. This couldn’t be farther from the truth. You are not alone, bladder and rectal issues are common, and you do not have to suffer in silence. 

33 million US adults experience issues from an overactive bladder. 

What Causes Urgency and Incontinence?

As we mentioned, there are many reasons why you could be experiencing urgency or incontinence. Speaking with a provider can help you to pinpoint what might be the root cause of your overactive bladder. 

  • Infections (such as urinary tract infections). 
  • Nervous system dysfunction.
  • Weak or damaged pelvic floor muscles, often from vaginal childbirth, can lead to experiencing leakage. 
  • Tight pelvic floor muscles (which can occur from not stretching enough) can lead to bladder urgency. 
  • Certain medications (diuretics, sedatives, and antidepressants).
  • Diseases such as multiple sclerosis, Parkinson’s disease, diabetes, stroke, and bladder cancer.  
  • Overweight/Obesity – even just a few extra pounds put more pressure on your bladder! 
  • Estrogen deficiency during and after perimenopause and menopause. 

One-third of women will have a pelvic health problem by the time they are 60.

Symptoms of an Overactive Bladder

Four main symptoms indicate you have an overactive bladder. If you experience any of these symptoms, it is important to schedule an appointment with your provider to discuss treatment options.  

  1. You frequently have a sudden (and typically very urgent) need to urinate. 
  2. You need to urinate more than eight times per day. 
  3. You experience incontinence (leakages) frequently. 
  4. You cannot get a full night’s rest because you are getting up to use the bathroom often.  
Treatment Solutions for Urgency and Incontinence

Managing symptoms associated with an overactive bladder is similar to managing symptoms of menopause – we always start with SEEDS® (Seven Essential Elements of Daily Success) and by making lifestyle adjustments. Depending on your personal experience, pelvic floor physical therapy and estrogen are treatment options to consider as well.  

SEEDS® and Lifestyle Adjustments:
  1. Monitoring your diet and managing your weight can significantly reduce bladder urgency. Extra weight places pressure on your bladder, can reduce blood flow, and damage nerve connections to the bladder. Even losing a few extra pounds can help to alleviate urgency symptoms.  
  2. Getting enough fiber in your diet is also important for maintaining both bladder and rectal health. When the body is constipated, unreleased stools can put pressure on your bladder, causing you to feel like you need to urinate more frequently. Constipation also can weaken pelvic floor muscles over time from having to strain with each bowel movement. 
  3. Getting enough of the right fluids each day is vital for bladder health. When you experience an overactive bladder, your knee-jerk reaction might be to limit your fluid intake for the day. Unfortunately, dehydration leads to further bladder irritation and urinary tract infections and can cause constipation (see above). Alcohol, caffeine, and carbonated drinks can also cause bladder irritation and act as a diuretic.  
Pelvic Floor Physical Therapy

Your pelvic floor is a delicate balance. If your pelvic floor muscles are weak, you likely will experience leakages, but if these same muscles are too tight, you can experience increased bladder urgency. A Pelvic Floor Physical Therapist can help you to strengthen and stretch your pelvic floor muscles through exercises, such as Kegels, to improve bladder function and urgency.

Hormone Therapy

As estrogen begins to decline during perimenopause and menopause, your body begins to lose collagen as well, causing the tissue around your bladder and pelvic floor to weaken. Collagen can decrease as much as 20% as your estrogen levels drop off! Taking estrogen or receiving laser treatments such as the MonaLisa Touch can rebalance estrogen levels in the body and promote the regrowth of collagen in the body. 

Dr. Bitner’s Tips For Bladder and Rectal Urgency
  1. Do some research to schedule an appointment with a healthcare provider and/or team that understands overactive bladders and urgency. It is important to work with a knowledgeable provider who will be able to provide recommendations and treatment solutions. 
  2. Don’t be shy! Ask your provider any and all questions about your bladder and rectal function. You deserve to feel more confident and participate in all of your favorite activities again. 
  3. Bladder and rectal leaking is not necessarily a sign of aging. These issues can happen at any age, and there are many reasons you might be experiencing urgency and incontinence. 
  4. Treatment options are available, and most do not include surgery. You do not need to suffer in silence! 
  5. You are more likely to experience urgency or leakage during menopause and perimenopause because of declining estrogen levels. Ask your provider about taking estrogen, seeing a pelvic floor physical therapist, or if laser therapy, such as the MonaLisa Touch, would be right for you. 

One-third of women will have a pelvic health problem by the time they are 60, and there are a variety of reasons you may experience urinary incontinence or bladder urgency. You should never ignore your symptoms if you suffer from these conditions! We understand that bladder or rectal urgency can be sensitive topics to bring up during an appointment, but it is the first step in getting help. No topic is off the table with Dr. Bitner and the true. Women’s Health team, and we look forward to helping you get back to a better quality of life soon.