Menopause comes for us all and is filled with generally not so fun side effects. Hot flashes, weird periods and mood swings, oh my! But wait - I'm having difficulty peeing? What TF? Bladder changes during menopause typically are misunderstood and take you off guard symptoms none of us know about. We are here to tell you what it is and most importantly what you can do to fix it!
Perimenopause is the slow transition toward menopause, when our ovaries sporadically produce eggs. Due to the slowing down of egg release, our hormones (specifically estrogen and progesterone) can become imbalanced. All of these changes can cause a slew of symptoms.
Perimenopause looks different from person to person. For some, it begins as early as their mid-30s, and for others it doesn’t show up until their mid-50s. Typically, this is a period of time up to 10 years before your final period where your hormone levels fluctuate greatly. This is also when most people experience the negative side effects.
Symptoms also range widely, but they most often include a combination of:
Another common (but less talked about) symptom of perimenopause is changes in bladder habits and function. Urinary urgency, urinary incontinence (like the infamous sneeze-pee), and urinary tract infections (UTIs) all become more common during this transition. Almost every cell in our body utilizes estrogen. Our bladder and genitals are no different!
Due to the severe drop in estrogen in the body, our bladders and pelvic floors begin to change and can become symptomatic.
Perimenopause Bladder problems due to low estrogen include:
That lack of estrogen weakens and thins the bladder wall, which makes urinary functions less predictable. These changes can also weaken the pelvic floor muscles, which reduces overall support for the bladder and urethra. The mucosa of our vaginal walls also love estrogen so this tissue also thins out, becomes less flexible, also causing problems.
Addressing Perimenopause Bladder Problems
Our bodies are complex and wonderfully made, so there is actually a lot we can do to help optimize our hormone levels to decrease symptoms. Here are our top recommendations:
Hormone Replacement Therapy is also an option for women. Just like any other medical intervention, there are pros and cons and you should visit with your health care provider to see if HRT is right for you!
One of the most helpful ways to ease bladder problems in perimenopause is with healthy bathroom habits. Check out these tips to get you on the right track.
While the just-in-case pee seems like a great idea, it can actually work against you.
As the bladder stretches to hold more urine, it sends us signals so we can start heading to the bathroom. With just-in-case peeing, we train our body to respond to bladder urges when it’s not quite at capacity. That means it’ll send signals that we have to go even if our bladders aren’t remotely full! Then, overtime, our bladders actually shrink, which leads to increased urinary frequency.
Bottom line? Only pee when you have the urge to go!
We don't need to stress or push to get pee out. Pushing down can cause extra stress on the muscles and structures causing more issues. Ideally, we want to sit, relax and just breathe! Some women may need to shift side to side or even stand up and sit back down to get it all out - that's okay!
I know we said early, go to the bathroom when you get the urge to pee, but sometimes we get the urge when we don't need to go! We call this a dramatic bladder. In general, we should be able to go a minimum of 2 hours between voids. If you get an urge to pee before this time period, we encourage you to try to suppress the urge. Here are some tips to do so:
Urinary symptoms in menopause can be stressful! When in doubt, seeing a pelvic floor PT can be huge to identify your exact issue and get a plan in place to help you overcome it. The main thing we want you to know is its not something you need to deal with or change your daily habits around - you deserve more!