Influence of Menopause
The bladder is dependent on estrogen, with estrogen effects seen in the urethra, bladder and pelvic floor muscles. With the falling level of estrogen which occurs around the time of the menopause and beyond, symptoms such as frequency, urgency, and nocturia, which may mimic symptoms of Overactive Bladder, may occur. Menopausal women may also suffer from urinary tract infections, stress incontinence and pain when passing urine (dysuria). Along with symptoms of vaginal dryness, irritation and pain during sexual activity, these menopausal symptoms are often referred to as “Intermediate” menopausal symptoms, occurring a few years after the last period, or a few years after stopping Hormone Replacement Therapy, although some women experience these symptoms early in the menopausal phase.
Symptoms are more common and often severe in women who smoke, due to increased break down and hence lower levels of estrogen.
Urge incontinence is more common after the menopause, and the most likely time to develop stress incontinence is around the time of the menopause. One report (ref 1) showed that 70% of postmenopausal women who suffer from incontinence, relate the onset of their incontinence to the time of their menopause.
Because of the association with bladder problems during and after the menopause, bladder and vaginal symptoms should be discussed during menopausal consultations.For more information about the menopause visit www.menopausematters.co.uk