Menopause causes a lot of changes in your bladder and urinary system in general. The most noticeable change is that, as your estrogen levels go down, the wall of your bladder gets thinner. Many women notice that they are urinating frequently or that they leak a little when they cough or sneeze. Other women notice that everything in that vicinity feels a little lower and looser. Urinary tract infections and some irritation during intercourse are also common complaints. Do not despair! Most of these changes will be mild, and a bit of prevention can keep your bladder functioning normally for many years to come. Here are some tips that can help.
Prevent Bladder Infections
Drink plenty of fluids. Some insist that unsweetened cranberry juice is an especially good choice, because it may make urine more acidic. Also, urinate regularly every two to three hours, but go when your bladder is comfortably full. If you do not drink enough fluid, your urine will be more concentrated, and the ammonia in your urine will irritate your bladder and vaginal tissues, leading to a vicious cycle of frequent urination and constant pressure and urgency. A consistent flow through the system will flush out your bladder and prevent bacterial growth.
Urinating right after intercourse is also helpful in flushing bacteria out of the urethra, the tube that goes into your bladder. Most women already know that it's important to always wipe from front to back, but it doesn't hurt to be reminded. Always wipe from the vagina towards the rectum, since bacteria that normally live in the rectum can cause vaginal and bladder infections. Women with hemorrhoids or frequent diarrhea must be especially careful, because it may be harder to keep the vaginal area clean. A little extra vigilance is important at midlife.
Strengthen Your Pelvic Muscles
Move those muscles! The muscles that strengthen bladder control need exercise, just like the rest of you. The muscle under the bladder, called the pubococcygeus muscle, can be exercised with the Kegel exercise. This is the muscle you tighten when you are trying to stop urinating in midstream. Tightening the muscle 10 to 20 times in a row, two or three times daily, can help prevent those embarrassing urine leaks. Also, get in the habit of tightening the pubococcygeus muscle every time you feel a cough or sneeze coming on; after a while, this will get to be second nature.
Exercises that involve strengthening the thighs indirectly help vaginal tone; these include bicycling, swimming, and other leg exercises. Jogging and high-impact aerobics, however, may actually make a weak bladder worse by increasing pressure on the bladder with repeated bounces and pounding.
Despite all of these precautions, women can have a number of serious bladder problems. Blood in the urine or persistent pain on urination can be a symptom of infection, cancer, or other chronic problems. Despite dozens of Kegel exercises, some women will have ongoing problems with incontinence, or their bladder will "drop" out of their vaginas (a condition referred to as prolapse).
Fortunately, most of these major problems can be treated with a combination of medicine and surgery. Newer approaches include physical therapy for the vaginal area. For many women, menopausal bladder problems may be treated as simply as using a lubricant for intercourse or a tiny amount of estrogen in the form of a vaginal cream, vaginal ring, or vaginal tablet. One major obstacle to the successful treatment of bladder problems is a widespread unwillingness to discuss the topic. Do not be too embarrassed to talk to your doctor about bladder problems; help is available.
