Weak bladder

A combination of factors can lead to a weakening of the bladder during this time of our lives.  

Lower levels of oestrogen can cause the lining of the bladder and urethra to weaken (much like it does to the vagina).  Weaker pelvic floor muscles may reduce the support for your organs, causing them to shift and drop (prolapse), which can impact how your bladder works.  And of course, if you’ve been pregnant and given birth before, then you will know the impact that this can have on your pelvic area… you may have even had a couple of leaky moments during pregnancy before.

The most common bladder problems that women may experience during menopause include:

• Stress incontinence: leaking when sneezing, coughing, intense laughing. It is caused by weak pelvic muscles and can get worse during menopause.
  Prolapse: this is when the organs in your pelvic region drop and can bulge into your vagina. This could include your bladder, uterus or rectum. Although more common in women who have given vaginal birth or had a hysterectomy, it can happen to anyone.
• Nocturia: waking up at night with the need to pee.
• Urinary frequency: the need to go to the bathroom repeatedly (like very often!!).
• Urinary Tract Infections (UTIs): while most women will experience a UTI at some point in her life, changes to the natural bacteria in and around the vagina during menopause can increase the likelihood and frequency of UTIs. Prolapse of the pelvic organs and not being able to completely empty your bladder can also fuel the flames of a UTI. These can be treated symptomatically (if not severe) or with antibiotics from your healthcare provider (if needed for more severe cases). If you find that you are having frequent UTIs (3 or 4 a year), then you may need to see a specialist to check for underlying causes and/or more intense treatments to stop the recurring infections.

Here are a couple of things that you can do to help manage a weak bladder during menopause.

• Watch out for irritants in your diet: There are some food types that can irritate the bladder and may increase the risk of leaks. Foods such as caffeine, alcohol, acidic fruits (tomatoes, citrus, fruit juices), soda (even the sugar free version!) and chocolate can all irritate your bladder. [You are probably wondering what good things are left in life without alcohol, chocolate, caffeine????]
• Bladder training: Remember how you trained your toddler all those years ago, to control their bladder and not just pee anywhere or anytime? Well, the same principles can work for you too, if you are experiencing frequent urges to dash to the bathroom. Start by slowing increasing the time between bathroom dashes – try holding out for an extra 10 or 15min at a time (or less, depending on how bad it might be). Any progress is good progress. Slowly, over a couple of months (not days!), you can retrain your bladder to manage longer periods between emptying. The goal is to make it 3-4 hours between bathroom breaks. But it will take time, patience and practice to get there. So be kind to yourself (and your bladder).
• Quit smoking: Yet another reason to stop smoking! Nicotine can irritate your bladder.
• Pelvic floor exercises: A strong pelvic floor can make the world of difference. These exercises are not only good for bladder health, but also help your vaginal area – so double the benefits for your efforts! Consider including some of the following:
  • Kegel exercises – work on strengthening the muscles that allow you to control your pee.
  • Pelvic floor physical therapy – you will need to consult your physiotherapist to work out a plan for you.
  • Yoga poses that focus on pelvic floor strength (e.g. wide-legged squat, warrior 2, cat-cow) – you could join a local yoga class or one of the many online resources to help you get started.

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Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.