Does Menopause Mean Loss of Control?

By Aileen M.K. Yee, M.D.
Urogynecologist

For many menopausal women, laughing so hard you wet your pants is not just a cliché. Incontinence — the involuntary loss of control of the bladder or bowels — is a common problem for women, especially during and after menopause.

Some doctors believe that in older women, the lack of the hormone estrogen, believed to keep bladder and urethra linings healthy, contributes to the weakness of bladder control muscles. However, studies have failed to prove a link. It could just be a coincidence that symptoms of incontinence are often noticed in a woman's early 50s, the time of menopause.

Other causes of incontinence, which have been proven, are childbirth and previous pelvic surgeries. Medical conditions like multiple sclerosis, diabetes, stroke and lower back injuries may also impact bladder control.

There are several types of incontinence. The most common in women are stress and urge incontinence. With stress incontinence the physical pressure of laughing and coughing can push urine past weakened muscles. With urge incontinence, the bladder muscle contracts at inappropriate times causing the sensation of urgency and at times leakage.

In 80% of all cases, incontinence can be managed effectively. However, fewer than half the women suffering with incontinence seek help from their doctor. In addition to greatly restricting a woman's activities, incontinence can lead to bladder and kidney infections.

Kapi'olani Women's Center offers various treatment options. In many cases, women can regain bladder control with simple solutions – dietary changes, muscle exercise, scheduled bathroom breaks and education. Medications are used primarily to control urge incontinence. Biofeedback and electrical stimulation can improve muscle strength, and minimally invasive surgery has proven to be very successful.

Incontinence is NOT a normal part of aging. Take control of incontinence. Call 535-7000.

August, 2004 Women's Health Column