How to Deal With Urinary Incontinence During Menopause

Contributed by Eric l. Mitchnick, MD, FACS- Guest Contributor

Rather than accept urinary incontinence as another inevitable and unavoidable side effect of menopause, you can embrace a range of simple and complex treatment options to stop and even prevent urinary incontinence symptoms, such as occasional bladder leakage and complete loss of bladder control.

One very simple process makes urinary incontinence especially common in women during menopause: the decrease of estrogen. When estrogen levels drop, they cause the pelvic muscles to weaken, thus making bladder control increasingly difficult. As menopause-related hormone levels continue to drop, the symptoms of urinary incontinence may worsen.

For women dealing with this embarrassing, though common, issue, I recommend three levels of treatment options: lifestyle changes, alternative medicines, and medications and surgery.

Finding the best treatment option for you begins by understanding the three main types of urinary incontinence in menopausal women: stress incontinence, urge incontinence, and overflow incontinence.

Stress Incontinence

The most common bladder control problem for women during menopause, stress incontinence happens when physical movement or activity – from a simple cough, sneeze, or laugh to running or heavy lifting – puts pressure on the bladder, reducing your sense of control, and resulting in leakage.

Losing a few drops during exercise or leisure activities is common in stress incontinence, welcoming embarrassment into everyday life. Managing stress incontinence with various treatment options can significantly improve your quality of life and overall well-being.

Urge Incontinence

Urge incontinence – the unintentional loss of urine caused by bladder muscle contraction – differs from stress incontinence, particularly in its sense of urgency.

Also known as “irritable” or “overactive” bladder, this type of urinary incontinence triggers an urge to pee so sudden and unexpected that many women hardly make it to the bathroom in time.

The constant urge to pee – even with an empty bladder – signifies one of the key symptoms of urge incontinence.

 Overflow Incontinence

Do you leak urine during the day? Wet the bed at night? Experience frequent or constant dribbling? Overflow incontinence – the inability to completely empty the bladder or control urination – may be rearing its ugly head.

This common type of urinary incontinence in women during menopause occurs when the bladder fills up and then overflows, causing leakage.

Weak urinary stream, nocturia (the urge to urinate at night), and urinary hesitancy, all caused by an under-active bladder muscle, may surface as byproducts of overflow incontinence.

Treatment Level 1: Lifestyle Changes

Rather than rush to a more drastic treatment option – an invasive surgical procedure, for example – start with a few simple lifestyle changes:

• Cut down on harmful substances including caffeine, alcohol and tobacco.
• Get a full 7 to 8 hours of sleep every night.
• Minimize stress with yoga, meditation and breathing exercises.
• Eat a balanced diet rich with supplemental vitamins B, C, D and E.
• Exercise (and hydrate) regularly.
• Strengthen the pelvic floor muscles with kegel exercises.

Treatment Level 2: Alternative Medicines

Alternative medicines stimulating the natural production of estrogen and other hormones can enhance the benefits of basic lifestyle changes to further reduce and prevent the different types of urinary incontinence.

Feel free to try a combination of alternative approaches with little to no health risk. Acupuncture, biofeedback, massage and aromatherapy and even certain herbs can all help women find safe and natural relief from urinary incontinence during menopause.

Treatment Level 3: Medications and Surgery

Reserved for prolonged or drastic cases, pharmaceutical and surgical treatment options enter the picture when simple lifestyle changes or alternative medicines fail to stop or prevent urinary incontinence.

On the plus side, medications and surgery can be more effective. Two big negatives are the potentially higher risks and costs.

Still, the benefits of pharmaceutical drugs may outweigh the risks including the (often inevitable) side effects. Talk to your doctor to find out if hormone replacement therapy and other medical or surgical options are right for you.

Eric I. Mitchnick, MD, FACS is a Board Certified Urologist at the Advanced Urology Centers of New York in Northport and Port Jefferson Station, NY. Throughout his 20+ years of practice and research, he has treated women and men dealing with incontinence and other urology conditions. Read more about Dr. Mitchnick’s expertise and practice at http://www.aucofny.com/eric-i-mitchnick-md-facs/, and read more about how to treat incontinence during different life stages at https://www.salkinc.com/blog/