A sudden sneeze sneaks up on you and oh great… you’ve weed yourself a bit.
Same goes for a spontaneous laugh, when you lift anything heavy or try to jump up and down (no trampolining for you today my love). And my word, when you need to go, you need to go NOW.
Incontinence – it’s never fun. Especially when it takes you by surprise. Which is always.
Whether it’s a few drops here and there, or a full-on accident, if you are battling with leaky bits you’re not the only one. Urinary incontinence affects millions of women ‘of a certain age’.
What causes bladder problems in the menopause? Well, hormonal changes (especially oestrogen going AWOL) can thin the lining of the urethra, the tube that takes pee from the bladder and out of your body.
Your surrounding stomach and pelvic muscles can also be affected by hormonal changes and cause your bladder to change position. Your female support structure will also weaken with age, a process known as ‘pelvic relaxation’ – which sounds like your nether regions are chilling in a deckchair somewhere while you stress about incontinence!
Add all this to the physical effects of pregnancy or childbirth and you may find you have stress incontinence, leaking when you sneeze or lift. You could have urge incontinence (also called ‘overactive bladder’) where you have a constant or sudden urge to wee, or overflow incontinence when your bladder doesn’t empty fully and dribbles all the time.
Our advice and guidance
You don’t have to accept bladder problems as unavoidable or inevitable during the menopause.
In many cases, there are things you can do to stop and even prevent urinary incontinence in addition to seeking advice from your GP.
Work it baby
Strengthening your pelvic floor (or kegel) muscles really helps if you’re struggling with a leaky bladder or frequent urinary tract infections.
You don’t need a gym or fancy equipment to train your pelvic floor either. All you need to do is contract and relax the muscles that stop you peeing. Start by doing this mid-flow to make sure you’ve identified the right ones. Work up to being able to do 10 five-second contractions in a row, three times a day.
Let’s talk (again) about sex
Leaking during intercourse can certainly dampen the mood. It can be so embarrassing that it leads to people worrying so much that they can’t enjoy themselves or it makes them avoid sex altogether.
If this is you, exercise to train your muscles. The bigger the muscles down there, the more control you will have – and the better your blood flow to the area will be, making the whole ride (excuse the pun) more pleasurable.
And don’t forget to go to the toilet just before you get jiggy with it.
Speak to your doctor
You could always also talk to your doctor about creams and vaginal suppositories that could help you manage your symptoms. A vaginal oestrogen does not usually increase the risk of blood clots or breast cancer and can significantly help symptoms of bladder irritation.
Wear the right kit
As you work on your bladder control, the good news is there are more and more pads, disposable and washable underwear that can keep leaks under wraps.
Try a few and find the right product for you. There’s no point doggedly holding on to your thong or dealing with a soggy gusset when you can be much more comfortable and relaxed.
Retrain your bladder
If you’re struggling with an overactive bladder, it is possible to retrain the connection between it and your brain.
The goal of bladder retraining is to cut down the number of times you piddle to six to eight a day. You do this by gradually increasing the length of time between your trips to the toilet.
When you feel the urge, don’t rush off to the loo. Sit still, firmly on a chair and tell yourself you can go in five minutes. Once five minutes isn’t a struggle, up it to 10, and so on, so forth.
Our advice to them
In terms of self-care, we’ve recommended that they work out their pelvic floor muscles to lessen the likelihood of leaks. We’ve also suggested they invests in some pee-proof undies to keep their confidence high.
The last thing someone needs when they’re dealing with bladder problems is for someone to draw attention to it by asking loudly in public: “Are you OK love, do you need the toilet?”
Instead, ask them if there’s anything you can do to help before any social situations. And please, don’t try to lighten the mood by making a joke about it. They might put on a brave face, but nine times out of 10 it’s not funny for them.
Ask them to explain
You may have needed the loo a million times, but have you been through menopausal bladder problems?
Don’t assume you know what the symptom feels like. Gently ask them to explain the effect it is having on them physically and emotionally.
You may not be able to do anything to make them feel better. But they may not want answers, they may just need to talk – and be properly heard. Switch your listening ears on and give them your full attention.
Encourage them to speak to a doctor
If their symptoms are putting serious strain on your relationship, they’ve been going on a while or seem to be getting worse, gently encourage them to speak to a GP. You could even offer to go to the appointment with them to show your support.
If you’d like more information, we have put some further references below for you: