The following is a summary of the relevant information, as well as a list of excellent resources for further reading about particular bladder problems.
VERY common! Australian statistical data from the Continence Foundation notes that:
[The following few sections are excerpts from Jean Hailes’ excellent “Bladder Incontinence” resource]
According to the Continence Foundation of Australia, a normal bladder:
|Types of incontinence||Signs and symptoms|
|Urge incontinence (urinary)||Bladder muscle contracts with little warning; you may feel:
|Stress incontinence (urinary)||Urine leaks when you exert yourself, such as when you sneeze, cough, laugh or jump, due to mobility in the bladder neck because of a weak pelvic floor.|
|Mixed incontinence||You experience both urge and stress symptoms.|
|Overflow incontinence||Occurs when the bladder fails to empty properly, becomes over-full and then tends to leak – it may be caused by poor contraction in the bladder muscle or by certain neurological or medical conditions, such as diabetes.|
The pelvic floor muscles – the ‘sling’ of muscles that supports the bladder, bowel and uterus – can stretch and weaken, leading to continence issues. The following may also contribute to incontinence:
One of the most common bladder problems at menopause is Overactive bladder (OAB): urinary urgency, usually accompanied by frequency and nocturia, with or without incontinence. With OAB you will suddenly have the urge to rush to the toilet with little or no warning, and you may experience a small or large amount of leakage if the urge isn’t controlled. The urge is often in response to “trigger” situations, like putting the key into the front door when you arrive home, or fiddling with the buttons to get your pants down.
Before menopause, a steady supply of estrogen helps preserve the strength and flexibility of your supportive pelvic and bladder tissues. During perimenopause and menopause, your estrogen levels drop dramatically. This can cause your tissues to weaken. Low estrogen levels may also contribute to a weakening in muscular pressure around your urethra. Changes in hormone levels may also increase the risk of urinary tract infections (UTIs) during perimenopause and menopause. UTIs may have similar symptoms as OAB.
In order to work out what type of bladder problem you have your doctor will ask a lot of questions about how, when and how much you urinate or leak. They will need to know about your other medical issues and medications. They may also check for UTI’s and ask you to complete a bladder diary; this is a record of how much you drink and urinate, and when. Your doctor may examine you, or recommend that you be assessed by a continence/ pelvic floor physiotherapist (like Marita). The examination usually involves a bimanual examination, where the health worker inserts their gloved fingers into your vagina to assess the strength and state of your pelvic floor. You may also be referred for a urodynamic study; a specialist doctor used a tiny tube (catheter) inserted into your urethra to fill the bladder, and then test the pressure and holding capacity of your bladder.
Check out our webinar video above for Marita’s tips on behavioural management, bladder training and more! MEDICAL TREATMENTS FOR OAB:
Australasian Menopause Society: https://www.menopause.org.au/hp/studies-published/610-oestrogens-and-overactive-bladder https://www.menopause.org.au/health-info/fact-sheets/urinary-incontinence-in-women The Royal Australian College of GP’s: https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome/ Continence Foundation of Australia: https://www.continence.org.au/ https://www.continence.org.au/about-continence/continence-health/bladder Jean Hailes information about bladder incontinence: https://www.jeanhailes.org.au/health-a-z/bladder-bowel/bladder-incontinence Healthline: https://www.healthline.com/health/menopause/overactive-bladder-menopause A DIY Bladder Diary: https://www.continence.org.au/resource/bladder-diary-instructions Bladder and Bowel Health Australia: https://www.bladderbowelhealth.org.au/ _______________________________________________________________________________________________________________________________________________
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