Have you heard the joke about the old woman who took a long time in the bathroom? I have. Far more times than I care to remember. Urinary incontinence and menopause go hand in hand according to popular culture – and not without reason. Ladies, our bodies go through some dramatic changes during menopause, there’s no getting around that. Now, that does not necessarily mean that incontinence is inevitable, but it is an unfortunate reality for too many women. Let’s review some of the science behind this association.
One of the biggest changes that occur in your body during menopause involves the decrease in estrogen production throughout the body. Estrogen, a hormone responsible for controlling the reproductive system and other sexual characteristics, helps maintain the function of the bladder. When estrogen is being produced normally, it lines the bladder and helps make sure that urine flows through smoothly. It lines the urethra as well, helping to make sure it has enough strength to carry out its function. When estrogen levels are lowered, the various muscles begin to weaken and the bladder/urethra are more likely to become dry and suffer from inflammation due to the lack of protection that estrogen provides earlier in life. Inflammation of the urinary tract can be a major risk factor for incontinence, as we’ve discussed before.
The drop-off in estrogen levels, independent of all other possible consequences, can cause general weakness in the bladder, urethra, and pelvic floor muscles, which will obviously wreak havoc on your ability to properly regulate your urination. When your body cannot properly regulate its urination, you become more susceptible to things like urinary tract infections (UTIs), which further increase the risk of urinary incontinence
During menopause, your body also becomes much more likely to experience something called pelvic organ prolapse; this involves one or more of the pelvic floor muscles drops down and pressures the vagina, sometimes even protruding a little bit in extreme cases. Women who have given birth vaginally are at a greater risk for this during menopause, as vaginal birth puts extreme stress on the pelvic floor muscles with the decrease in estrogen exacerbating the issue. Naturally, when various muscles are weakened, they are less likely to retain their proper position. The pelvic floor muscles are especially susceptible to this because of their unique position and function in the body.
One of the treatments often prescribed to treat urinary incontinence in women who have gone through menopause is hormone therapy, in which estrogen supplements are used to make up for the decrease in production of natural estrogen. That doesn’t necessarily seem like a bad idea, but the treatment carries some possible risks. Certain forms of hormone therapy are thought to carry an increased risk of breast cancer, endometrial cancer, or dementia. Weirdly, certain forms of hormone therapy are thought to increase the risk of urinary incontinence, so that essentially defeats the entire purpose of the treatment.
A device such as the Yarlap® is the optimal treatment for menopausal women with urinary incontinence. The Yarlap® uses very low electrical pulses to force the pelvic floor muscles to expand and contract, essentially retraining the muscles and getting them back to the shape they were in during adulthood. When the pelvic floor muscles weaken, they tighten and become inflexible. The Yarlap® allows for those muscles to regain their flexibility so they can properly stretch and allow urine to pass through. It also only needs to be used for around 20 minutes a day, and you can accomplish many other tasks while it’s in.