You laugh, cough or sneeze… and suddenly you feel a familiar dampness, hoping no one noticed. You make a habit of going to the toilet “just in case.” Exercise feels like a gamble. Your always tired because you never make it back to sleep after that 1am trip to the toilet.
You’re not alone, urinary incontinence is extremely common particularly for women in perimenopause/menopause. It is estimated that up to 60% of peri/menopausal women experience urinary incontinence.
Luckily, there are effective management options, but first we need to understand why it is happening.
There are two main types of urinary incontinence (and you can have both types ‘mixed’)
- Stress Urinary Incontinence: urine leakage as a result of physical activity. Pelvic floor muscles support the bladder and the urethra (the tube that carries urine from bladder to outside of body). If these muscles are weakened (eg. as a result of reduced estrogen levels or following childbirth), they can’t maintain closure of the urethra during pressure increases – for example those that occur during coughing, laughing, physical activity, heavy lifting etc- and urine leaks out.
- Urge Urinary Incontinence: is the incontinence that results from not being able to ‘hold on’ until a convenient time, or that uncontrollable and sudden urge to urinate and is a result of an overactive bladder. Estrogen plays a role in maintaining the bladder tissue (which is actually a muscle); decreased levels lead to thinning and reduced elasticity. As a result it can’t stretch as well and activates when it collects even small volumes of urine. The sudden urge to wee when you do a specific activity like put your key in the front door, or when you hear or visualise water running are signs of UUI, as is needing to wake up multiple times during the night to go to the toilet.
It is important to understand which type of incontinence you suffer from as the treatment can differ- discuss with an ALLY Health doctor today.
What can be done?
- Lifestyle changes: anything that reduces pressure on the bladder/urethra can help with stress incontinence: weight reduction, avoiding constipation with a high fibre diet, avoiding heavy lifting/high impact physical activity, addressing causes of chronic cough, avoidance of bladder irritants (alcohol, caffeine, fizzy drinks)
- Pelvic floor exercises to increase strength and control
- Bladder retraining
- Pessaries: pessaries offer mechanical support (inserted by physiotherapist or doctor)
- Topical estrogen
- Medications that allow the bladder to relax by blocking receptors cause its contraction (and associated urge) – eg. anti-cholinergic medications, mirabegron.
- Surgical Management
Book a free discovery consultation with the ALLY Health team to discuss you best treatment options
