What is the Connection Between Menopause and Overactive Bladder?

Christina Dodd 

What Is Overactive Bladder (“OAB”)

The bladder is a muscular sac in the pelvis, located above and behind the pubic bone. When empty, the bladder is about the size and shape of a pear. An overactive bladder is the result of a sudden, involuntary contraction of the walls in this muscle sac, it is a form of urinary incontinence. Urine starts in the kidneys and moves down the ureters to the bladder, where it is stored until a voluntary muscle reaction empties the bladder. The sensation of an overactive bladder is a need to urinate immediately, even though the bladder isn’t full of urine.

 Menopause and Overactive Bladder

For women between the ages of 45 and 55, an overactive bladder is a normal symptom of menopause. During the stages of menopause, estrogen hormone levels decrease, which affects the walls and tissues of the urethra, making them weak. Menopause causes the vaginal walls to become tissue thin and to become dry. Due to its close proximity to the bladder, the bladder becomes more sensitive to irritation and more susceptible to triggers that tells it that it should empty the urine, whether a woman is ready to urinate or not. A lack of estrogen in a menopausal woman’s body is responsible for maintaining bladder control, but due to its weakness, there are urine incontinence occurrences.

What Else Can Cause Bladder Control Problems in Older Women?

Nearly 33 million Americans have OAB problems and this statistics only factors in the people who have reported it. Even though older women are subject to incontinence, about 1 out of 6 men also experience bladder control issues. Some conditions other than menopause, that causes urinary incontinence in older women are constipation, childbirth pelvic muscles that have been weakened, medications that causes muscle relaxation, being overweight, urinary tract infections, and diseases like diabetes nerve damage, stress, depression, sleep apnea, stroke, and prostate conditions. Additional lifestyle habits can also cause an overactive bladder, such as smoking cigarettes, drinking too much caffeine, and drinking alcohol.

What Kinds of Bladder Control Problems Can Happen With Menopause?

The most common types of bladder control problems during menopause includes “stress” incontinence which happens when the pressures from coughing, laughing, and sneezing can cause leakage. The “urge” bladder control problem is when you feel an urge to urinate, but your bladder involuntarily squeezes to relieve urine, at the wrong time. Nocturia is a form of urination pressure that keeps you awake throughout the night, having to urinate. Painful urination is another bladder infection symptoms control problem with menopause, which causes pain during urination.

How Is OAB Diagnosed?

To diagnose an OAB problem, there are a number of tests and physical exams that physicians can run today, such as a “uroflowmetry,” which uses a funnel that women urine into and its contents are measured, including the speed of the urine flow, to see if there are any obstructions. A “urinalysis,” is performed to see if there are any unknown substances in the urine and to check for any conditions that can cause bladder control problems. An “ultrasound,” can also be used to measure the amount of urine in the bladder of a menopausal women, after urination. An ultrasound test also provides information about the cause of urinary incontinence, like an obstruction, urine flow, or if an older woman has a weak bladder muscle.

Treatments for Menopause-related OAB

A physician will work with their older women in order to analyze the type of OAB that they are experiencing and work up a good treatment plan, that can be based on lifestyle changes, medications, or in extreme cases, a surgical solution. However, common menopause treatment for related OAB includes Kegel exercises, which are a part of bladder training, that helps a menopausal woman strengthen her pelvic muscles to prevent urinary incontinence. There is also vaginal weight training where menopausal women hold light weights within the vagina to tighten the muscles. Another type of help is the “pelvic floor electrical stimulation,” technique that allows mild electrical pulses that help to stimulate muscle contractions.

Final OAB and Menopause Thoughts

Menopause is the normal time of change in a woman’s life, but what comes with it are symptoms, like the inability to hold urine in the bladder or loss of bowel control. OAB is more common in menopausal women, but about 17% of women over the age of 18, experience some form of OAB, but after the age of 40, this number is increased by 20%. Menopausal women shouldn’t fee embarrassed about discussing this problem with their physician. Without help for OAB, incontinence does not go away on its own and can easily become worse. Seek help because there are many methods and options that can help to treat embarrassing bladder control problems.


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