Help For An Overactive Bladder (OAB)

Nothing is more distressing than losing urine and unable to reach a toilet in a timely fashion. It is a source of embarrassment, anxiety, and even depression.

Your bladder can start to present problems at menopause as sneezing, laughing, increased urgency and frequent night calls can disturb your sleep and your peace of mind.

This is particularly true at menopause when up to 40% of women are affected by OAB. Unfairly perhaps, but women do suffer urinary incontinence four to five times as often as men.
Some of that has to do with pregnancy and childbirth, which can weaken the vagina, the pelvic floor muscles, and the ligaments that support the bladder. This can cause the bladder to be pushed out of place, making it harder for the muscles to perform. That’s why you may leak a little urine when you sneeze, cough, or laugh.

Symptoms of OAB:
* increased urinary frequency
* a sudden urge to urinate
* the need to urinate during the night
* difficulty getting to the bathroom without leaking

Types of Incontinence
There are two separate types of incontinence:
Type 1: Stress incontinence leads to leakage of urine when the pressure in the abdomen is higher than the sphincter pressure. Normally, contraction of the pelvic floor muscles compresses the urethra [bladder outlet] and prevents loss of urine and stress incontinence. Loss can happen with sneezing, coughing and during exercise such as lifting, jumping and walking.
Type 2: Urge incontinence is when an uncontrollable need to pass urine occurs due to over activity of the bladder wall muscle. Typically this occurs as you put the key in the front door or when water is running. There is generally no weakness in the pelvic floor muscles or muscles controlling the bladder outlet. This is also known as overactive bladder syndrome.

Mixed incontinence occurs when there is muscle weakness and and uncontrollable urge to go to the toilet together.

The hormone factor
For women, the bladder and urethra have hormone receptors and it is estrogen that affects the health of the pelvic muscles and the urinary tract. It is estrogen that helps to preserve the strength and flexibility of supportive pelvic and bladder tissues so low levels may be part of the reason these supportive tissues sometimes weaken as a woman ages and may also contribute to muscular pressure around the urethra.
Estrogen can improve the flow of blood and strengthen the tissue around the urethra so women who are low in body weight at menopause may not be producing sufficient for this purpose. Often prescribed are low-dose topical estrogen creams or patches but according to the Mayo Clinic, scientific evidence to support this treatment is lacking.
Low estrogen generally indicates even lower progesterone levels so a combination cream of both hormones can be effective.

When to get help
Bladder weakness can affect many areas of your life from disturbed sleep, to your sex life and embarrassment in public over urinary accidents. This can make it hard to enjoy everyday activities and so many women don’t seek help but these signs indicate you have a problem:
• urinate more than eight times in a 24-hour period
• get up in the night to urinate
• experience frequent leaking
• have changed your activities to accommodate your symptoms

How to help yourself
There are many types of surgery for stress incontinence and although this can be helpful, as time goes by a number of women will get a return of their urine leakage between 5 to 10 years after surgery. It is better to try and manage the condition by first trying pelvic floor muscle exercises which are an inexpensive and effective method of treating mild stress incontinence.

Often referred to as Kegel exercises you could follow the plan below. First you need to be able to identify your pelvic floor muscles and learn how to contract and relax them. To do this, stop urination in midstream. If you succeed, you’ve got the right muscles. Then practice this as below:
* Once you’ve identified your pelvic floor muscles, empty your bladder and lie on your back. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
* Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
* Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day.
More information:
Unfortunately at menopause women tend to put on weight, and being overweight can make bladder problems more common. Sleep at menopause is also often disturbed for this reason and for this progesterone does help aid sleep and rebalance hormones to help with any weight loss.
However for women who do need additional estrogen as well as progesterone and are not overweight a combination cream is usually more effective for the bladder.

Bottom Line: Incontinence and OAB are common maladies affecting millions of American women. You don’t have to depend on Depends! Help is available. Speak to your doctor.

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