Many women, on the cusp of menopause, experience perhaps the most embarrassing symptom of all menopausal symptoms: urinary incontinence. They tend to notice the lack of bladder control especially when sneezing or laughing.
As a woman approaches menopause, her hormone production begins to decrease, which leads to a multitude of physical changes, including incontinence. To understand how to treat this symptom, it’s best to first understand exactly what it is, what causes it, and finally, what treatment options are available.

What is incontinence

Urinary incontinence is the inability to control one’s bladder. The severity can vary from woman to woman. Some women may experience occasional trickles of urine when bursting into laughter or while having a sneezing episode. Others might notice large amounts of and more frequent uncontrolled urine flows that don’t seem to be stimulated by laughter or a body- shaking sneeze.
Although many women experience incontinence as they approach menopause it isn’t an inevitable aspect of getting older. But understanding this menopausal symptom can help to prevent or treat it. A good place to begin is with the different types of incontinence, of which there are three.

Types of incontinence

There are three main types of incontinence: stress incontinence, urge incontinence, and overflow incontinence. These types of incontinence are described in detail below.

Stress incontinence – is the most prominent type of incontinence experienced by women, especially women who are approaching menopause or who are post- menopausal. Women with stress incontinence involuntarily leak urine while coughing, laughing, sneezing, exercising, or lifting something. The reason these activities can cause incontinence is because they apply sudden pressure to the bladder walls, which squeezes the bladder and causes urine to leak out. The reason this occurs as women get older is because the pelvic muscles often grow weaker, which weakens the walls between the bladder and vagina.

Urge incontinence – is the sudden, intense, and frequent urge to urinate, immediately followed by an uncontrollable loss of urine. The bladder contracts and may give a warning of only a few seconds or a minute to make it to the restroom. Urge incontinence strikes especially while sleeping, drinking, or while listening to running water. Urge incontinence goes by other names as well: spastic bladder, overactive bladder, or reflex incontinence. This type of incontinence, characterized by the need to urinate more than seven times a day or more than twice each night, is the most common type of incontinence in elderly people.

Overflow incontinence – is characterized by frequent or constant dribbling urine. Those with overflow incontinence are unable to completely empty the bladder, which fills up and then overflows, causing leakage. Sufferers of overflow incontinence often have the sensation of never fully emptying their bladder, and when they urinate, they produce only a weak stream of urine. This type of incontinence is common with people who have damaged bladders or blocked urethras. It can also be a result of nerve damage from diabetes.

As already mentioned above, the symptoms of incontinence include: urine leaks during a sneeze, laugh, or cough; urine leaks when lifting or running; not enough time to reach a toilet once the urge to urinate is felt; urine continues to dribble after urinating; urine leakage follows an intense desire to empty the bladder; and continual leakage of urine.

What causes incontinence?

Because stress incontinence is the most common type of incontinence for women embarking on menopause and women who are postmenopausal, it’s appropriate to begin there. This type of incontinence in women is almost always caused by hormonal imbalance, specifically decreased levels of oestrogen.
Oestrogen helps to keep a woman’s muscles strong, even the muscles that enable her to maintain control of her bladder. oestrogen also contributes to the health of the urinary tract lining. When oestrogen levels begin to drop, as they do as women approach menopause, the muscles weaken and the bladder is more difficult to control.
Other causes of incontinence Although decreased oestrogen levels primarily cause incontinence in women going through menopause, there are additional causes of incontinence, but they tend to be more closely aligned with urge or overflow incontinence.

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