Bladder Health

Bladder-control difficulties are common among women after menopause. In fact, 10 to 30 percent of post-menopausal women experience some form of urinary incontinence, often during exercise or with laughing or sneezing. Three types of incontinence can occur: urge incontinence (when the bladder fails to store urine); stress incontinence (when the urethra, the valve that closes the bladder, fails); or mixed incontinence (when urge and stress incontinence happen at the same time). Urge incontinence tends to persist in the years following menopause, while stress incontinence is most prevalent during the perimenopausal years.

While you may feel embarrassed to discuss bladder control issues with your health-care provider, urinary incontinence is completely normal and treatable. Addressing bladder-control issues is important: corrective options can help you avoid longer-term health problems such as frequent urinary tract and/or vaginal infections, and vaginal bleeding.

How to treat stress incontinence

A variety of solutions exist. Pelvic Kegel exercises (those commonly recommended after childbirth to prevent moments of urine leakage) help strengthen your urinary tract. Kegel exercises strengthen the pelvic floor muscles. Pelvic floor is made of several layers of muscles which help support organs such as uterus, bladder and rectum. In addition to holding these organs in place, they control the bladder mechanism to keep the urine from flowing out unexpectedly. If pelvic floor muscles are weakened, urinary loss may occur, often when coughing, sneezing or exercising.

Vaginal cones were developed as a way to make it easier for women to exercise their pelvic muscles and may be recommended for women with stress incontinence. Vaginal cones come in different weights; a woman using them starts with the lightest cone until she feels comfortable enough to move up to a slightly heavier cone. She pursues her exercise program by moving up from one cone to the next until she is able to keep in place the heaviest cone for fifteen minutes.

Mechanical devices such as a pessary also offer support. Lifestyle changes such as weight loss, quitting smoking and reducing caffeine consumption can also be very effective.

Recent innovations in urinary incontinence medications offer the promise of fewer and less severe adverse effects and, thus, better treatment outcomes for patients. Two drugs, tolterodine and oxybutynin, have “longacting” or “extended release” formulations. With these, a patient needs to take only one pill per day, and there may be fewer adverse effects because the long-acting formulations are more stable than the original versions.

Small changes to your daily routine such as drinking less water or other beverages and making more regular visits to the ladies’ room can help, too. In some cases, hormone therapy or permanent surgical intervention are options to consider. Although success rates vary among women, as many as 60 percent report improvement or cure three months after therapy. Your health-care provider can help you determine which solution is best for you.

Some studies show that drinking cranberry-lingonberry juice concentrate can reduce the risk of urinary tract infections. Estrogen therapy has also proven to reduce the recurrence of urinary tract infections in some postmenopausal women.

The key to dealing with incontinence is proper diagnosis and persistence in following a treatment plan. Read the Urinary Incontinence Fact Sheet for more information.

Concerned about occasional urinary leaks? Download this Self-Questionnaire on Urinary Incontinence – it’s a good way to start the conversation about bladder weakness during your next doctor’s appointment

View the new Canadian Continence Foundation guide to continence care, management and treatment "The Source" the first complete continence resource book.

Read the study by the Canadian Continence Foundation "Incontinence: A Canadian Perspective".

Watch the Canadian Continence Foundation 30 second public service announcement video on the many faces of incontinence in Canada.

View this urinary incontinence decision tool by the Registered Nurses‘ Association of Ontario (RNAO) and Echo: Improving Women‘s Health in Ontario. This tool was designed to guide women through the process of considering incontinence symptoms, weighing treatment options, and discussing the problem with their primary health care provider.

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SOGC

"I was embarassed about having an 'accident' when I sneezed. I thought it was just part of aging. Now I know I don't have to live with it - there is something I can do about it."