If you are a woman in menopause who has started to experience the sudden urge to urinate with no ability to hold it, you are not alone. Urinary incontinence (UI) is a common condition among older women, especially those undergoing the hormonal changes that accompany menopause. There are several causes of urinary incontinence, most of which are related to the effects of aging.
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Estrogen plays a vital and prominent role in the health of your urinary system. It is responsible for maintaining your pelvic muscle strength, which is what allows you to control when you urinate. Once you reach menopause, however, your estrogen levels naturally decline.
Lower estrogen can also lead to thinning of the urethra and bladder lining, which also contributes to control issues. This lining is composed of several layers of fibroelastic connective tissues and smooth muscles, which work together to prevent leakage. As these layers weaken, the urethra?s ability to hold back urine can be compromised.
The muscles of your pelvic floor support your uterus, bowels, and bladder, contributing to urinary tract control. As you age, these muscles can ‘relax,’ making the control more difficult.
In addition to affecting your estrogen levels, menopause can also cause or exacerbate pelvic floor relaxation due to less testosterone. Androgen hormones, like testosterone, promote the building of muscles. Therefore, androgen production plummets upon reaching menopause.
The pelvic floor muscles are also strongly impacted during childbirth. Individuals who have delivered vaginally can be at increased risk of urinary incontinence later in life.
One particular type of incontinence that can affect women of all ages is stress incontinence, involving the loss of urinary control due to sudden movements or exertion, including:
- Heavy lifting
While occasional stress incontinence is not uncommon, it can become an ongoing concern in older and menopausal women as low hormone levels weaken muscles.
Problems with your bladder muscles can also cause urinary incontinence. Under-activity can lead to overflow incontinence, which is when your bladder does not empty. Common symptoms are increased urinary hesitancy, continuous urine dribbling, and nocturia, which is a condition that causes frequent urination during the night.
On the other hand, you may experience urge incontinence, also known as overactive bladder. Urge incontinence occurs when muscles overwork and squeeze continuously, which can lead to enduring the feeling of having to urinate even when you may not need to.
Other Urinary Incontinence Causes
Not all urinary incontinence is caused by hormonal changes. Leakage can occur as a result of several different factors, including:
- Obesity: Being overweight can lead to weakened pelvic floor muscles.
- Beverage Choices: Caffeinated and alcoholic beverages can cause frequent urination.
- Constipation: Your pelvic floor muscles can be weakened by chronic constipation.
- Infections: An infection in your bladder or urinary tract can cause UI as well as pelvic pain.
- Nerve Damage: Damage to nerves can mean your brain doesn?t receive signals indicating you need to urinate, leading to leakage.
- Medication Side Effects: Steroids and diuretics can cause frequent urination.
These factors can affect individuals of all ages but are relatively easy to address with medical treatment or lifestyle changes.