Also called urinary incontinence, bladder control problems are common for women going through menopause. But, there are many options available to treat bladder control problems.

How does menopause affect bladder control?

After your periods end, your body stops making the female hormone estrogen. In addition to controlling your monthly periods and body changes during pregnancy, estrogen also helps keep the lining of the bladder and the urethra healthy.

As we age, many factors can weaken the pelvic floor muscles responsible for bladder control resulting in urinary incontinence. This includes damage during pregnancy, childbirth, and weight gain.

What kind of bladder control problems can I develop after menopause?

  • Stress incontinence. Pressure from coughing, sneezing, or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence. It is one of the most common kinds of bladder control problems in older women.
  • Urge incontinence. Urge incontinence is another very common bladder control problem. With this condition, the bladder muscles squeeze at the wrong time -- or all the time -- and cause leaks.
  • Painful urination.
  • Nocturia. Need to get out of bed to urinate several times a night.

What else can cause bladder control problems in older women?

Menopause may not be the only reason for bladder control problems. There are other medical conditions that can cause incontinence, including:

  • Infections
  • Previous pregnancies
  • Nerve damage from diabetes or stroke
  • Heart problems
  • Medications such as diuretics ("water pills"), tranquilizers
  • Depression
  • Difficulty walking or moving
  • Weight gain

In addition, smoking cigarettes, drinking alcohol and/ or caffeine can contribute to a bladder control problem.

How are bladder control problems diagnosed?

First, your doctor will obtain a detailed medical history and perform a physical examination, including a pelvic exam. Your urine will also be tested for signs of infection or other problems.

In addition, your doctor may recommend that you keep a voiding diary, recording your symptoms and the situations in which they occur. This may help narrow the cause of your problem, and aid in determining the best treatment.

What treatments are available for bladder control problems?

Treatment depends on the kind of bladder control problem you have. Your doctor may recommend some of the following lifestyle changes:

  • Limiting caffeine consumption
  • Avoiding bladder irritants such as alcohol, carbonated beverages, and spicy foods
  • Strengthening pelvic muscles with Kegel exercises. These exercises strengthen your pelvic floor muscles. To do Kegel exercises, you squeeze and hold the pelvic muscles and then relax them. If you are unsure how to do Kegel exercises, ask your doctor to show you.
  • Training the bladder to hold more urine

If these simple treatments do not work, there are other options, including:

  • Medication such as tolterodine (Detrol®), oxybutynin (Ditropan®), trospium (Sanctura®), solifenacin (Vesicare), fesoterodine (Toviaz), or darifenacin (Enablex®)
  • Biofeedback, which is a method of learning to voluntarily control certain body functions with the help of a special machine
  • Electrical stimulation of pelvic muscles
  • A device inserted in the vagina to hold up the bladder (pessary)
  • A device inserted directly into the urethra to block leakage
  • Surgery to lift a sagging bladder into a better position

Estrogen therapy is not FDA-approved for the treatment of incontinence, but local vaginal estrogen may reduce recurrent urinary tract infections and is recommended by national guidelines to treat minor bladder symptoms in post-menopausal women.

What provider do I see about my bladder control problem?

Professionals who can help you with bladder control include:

  • Your primary care doctor
  • A gynecologist (a doctor who specializes in women's health care)
  • A urogynecologist (an expert in women's bladder problems)
  • A urologist (an expert in bladder problems)
  • A nurse practitioner or physician’s assistant
  • A physical therapist

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/3/2015...#10081