Involuntary Urine Release

Many women are subject to urinary tract infections (UTIs) on and off throughout their adult lives. But this problem can worsen during peri-menopause. Estrogen contributes to the growth and nourishment of all cells and tissues. Because your body produces lower levels of estrogen during the years leading to menopause, the tissues lining the urinary tract can grow thin and more prone to bacterial infection and inflammation. That same lack of estrogen-induced nourishment can weaken the muscles that surround your bladder and urethra. As a result, you experience more UTIs and other urinary tract disorders, a weaker bladder, and less control over urine release.

The most common kinds of urinary tract disorders women experience during perimenopause are stress urinary incontinence, urge incontinence, and UTIs. These disorders can have similar symptoms, but their causes and treatments are very different.

Urinary Tract Infections

Urinary tract infections are caused by bacteria in the urinary tract. The symptoms of UTI include feeling as though you need to urinate all the time, even when your bladder is empty; a burning sensation during urination; and — infrequently — small amounts of blood in your urine. Urinary tract infections can seem to fade, then return again. It's important to remember that, as with any bacterial infections, a full-blown UTI won't go away without antibiotic treatment. If left unchecked, the bacteria that cause a simple bladder infection can spread to the kidneys, causing a much more serious infection called pyelonephritis.

Fact

Many urinary tract disorders have similar symptoms, but require different treatments. If you suffer from burning or too frequent urination, involuntary urine release, or a constant full bladder feeling, see your doctor for an accurate diagnosis and treatment.

Urge Incontinence

Urge incontinence is the result of a bladder spasm that forces urine out, even when the bladder is not completely full. These involuntary muscle contractions cause the bladder to release urine in varying amounts. Even though the woman may not feel as though her bladder is full and she needs to urinate, the sight, sound, or even thought of water or urination can cause the sudden reflex need to urinate and an accompanying release of urine.

Stress Incontinence

Stress urinary incontinence is another cause of periodic involuntary urine release. Unlike urge incontinence that can result from the mere thought of emptying the bladder, stress incontinence usually has a specific triggering event, such as a sneeze or cough. Some women release small amounts of urine when they bend over, laugh, or exercise.

Stress urinary incontinence is caused by weakened sphincter muscles, which surround the urethra, and can occur in women of any age. Women who have given birth, regardless of the type of delivery, often experience this disorder many years before they approach menopause. But during menopause, weakening sphincter muscles can contribute to the onset of stress urinary incontinence, even in women who have never had a pregnancy. Obesity and chronic lung conditions that produce a lot of coughing, such as emphysema or cigarette smoking, can also cause or aggravate the condition. There are several approaches that seem to improve this condition, including:

  • A specific strengthening exercise called the Kegel exercise

  • Physical therapy with biofeedback and pessaries — small devices worn in the vagina to support the weakened urethral muscles

  • Surgery

  • Weight loss

  • Quitting smoking

If you begin to notice stress urinary incontinence when you cough or laugh, talk to your health care provider about these treatments.

Essential

A number of therapies can help end many urinary tract disorders. Biofeedback, pelvic floor muscle exercises (known as Kegel exercises), and medication are just some treatment possibilities. Weight loss and bladder retraining can be successful tools in fighting incontinence, too. Talk with your doctor to learn more.

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