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Menopause symptoms and treatments.


During the menopausal phase, numerous physiological transformations occur in women, one of which includes urinary incontinence. Incontinence denotes the involuntary loss of bladder control, leading to urine leakage. Hormonal shifts, particularly the reduction in estrogen levels during menopause, significantly influence alterations in the urinary system, contributing to the weakening of both the pelvic floor muscles and the urethra. This weakening can result in stress incontinence, characterized by urine leakage due to pressure exerted on the bladder during actions like sneezing, coughing, or physical exertion, as well as urge incontinence, which involves a sudden and compelling urge to urinate, often followed by unintended leakage.

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Factors contributing to incontinence in the menopause

Changes in hormones: The pelvic muscles and tissues that support the bladder and urethra can become less elastic and strong as oestrogen levels fall throughout menopause. Urinary incontinence may develop or worsen as a result of this hormonal imbalance.

Urogenital atrophy: Urogenital atrophy refers to the weakening, dryness, and inflammation of the tissues of the vagina and urinary system as a result of low oestrogen levels. Increased frequency, urgency, and incontinence are just a few of the urinary symptoms of this condition.

Weakening of pelvic muscles: The loss of estrogen can result in weakened pelvic floor muscles, which are responsible for controlling the flow of urine. Weak pelvic muscles can lead to stress urinary incontinence, where urine leakage occurs during physical activities such as coughing, sneezing, laughing, or exercising.

Approaches to managing incontinence

Exercises for the pelvic floor: Regular pelvic floor exercises can improve pelvic muscle strength and enhance bladder control. The muscles that control continence are contracted and relaxed during these activities. Using an App such as Squeezy or a device such as an Elvie Trainer can be helpful. A pelvic floor Physiotherapist can also support you with this.

Behavioural strategies: Applying bladder training strategies like delayed urination and scheduled voiding will aid with bladder control and lessen the frequency of incontinence episodes.

Lifestyle changes: Making some lifestyle adjustments, such as keeping a healthy weight, drinking plenty of water, avoiding bladder irritants like caffeine and alcohol, and adopting good bowel habits like not straining and ensuring complete emptying, can help manage incontinence symptoms.

Medical interventions: In cases of incontinence that are more severe, your doctor may suggest further treatments including drugs, devices (like pessaries), or even surgery to assist manage and relieve incontinence symptoms.

Vaginal oestrogen therapy: This treatment may be suggested for females who have urogenital atrophy. This entails using oestrogen creams, tablets, or rings to replenish moisture and suppleness to the vaginal tissues, which might lessen symptoms related to urine incontinence.