Why am I Leaking Urine after Menopause?
You have already gone through a bunch of changes during menopause and now you are suffering from urine leaks or incontinence. Urinary incontinence after menopause is common. In fact at least 50% or women over the age of 65 suffer from a common form of incontinence like stress, urge, or mixed urinary incontinence. But you want to know why.
When we go through menopause we lose estrogen, & estrogen keeps our tissues, even in our pelvic floor, nice and plump. This allows our pelvic floor muscles to close off our urethra when we urinate. When we start to lose our hormones, there is an atrophying effect. All of our muscles atrophy & our pelvic floor muscles are no different. Incontinence after menopause is partially that our pelvic floor muscles are atrophying, & partially that the rest of our tissues are not as plump preventing our urethra from closing the way it did when we were young.
If you weren't experiencing any leaking and all of a sudden you go through menopause, the source of your leaking is a combination of the lack of hormones and weakness. Poor neuromuscular control of your pelvic floor (not being able to properly Kegel or complete a pelvic floor muscle contraction) in combination with losing your hormones leads to lost bulk in your pelvic floor and then we start leaking more. But it can be stopped! The stronger you get, the less you will leak you can still stop leaking even though your hormones are depleting.
How do I Stop Leaking Urine after Menopause ?
When women go through menopause, we lose hormones (including estrogen and progesterone) and our tissues become smaller, or atrophy. We have muscles around the opening the urethra, which are responsible for closing the urethra off. But when these muscles lack strength and become smaller after menopause, those muscles are not strong enough to close off the bottom of the urethra, and you leak urine. So, you need to get the pelvic floor muscles strong, so you can close off the urethra and prevent urine leaks.
This means you have to do a lot of pelvic floor muscle contractions, or Kegels, they are the same thing. You also want your hip muscles to be strong enough, your stomach muscles to be strong enough, and you need coordination between your breathing and your muscles contracting and relaxing. When you cough, sneeze, or laugh, you should actually do a little Kegel, which happens best with a forceful exhale of your breath. To do this, you will have to train yourself to do Kegels when you exhale. If that seems like a lot, a pelvic floor physical therapist can help you get there.
When you are Kegeling, I say you need to do three sets of 10, morning, noon, and night, for 90 total throughout the day. This is 10-second holds, 10 times for each set. You also need to do 10 quick flicks (contract and relax 10 times in 10 seconds) following each set to get the best results.
If you cannot let go of your Kegel, all the Kegels in the world will not help you. So, if you are having any sort of pain, or if you don’t know how to contract and relax a Kegel (don’t worry most women can’t do them properly at first), you need to speak with a pelvic floor physical therapist. If you have any other questions about incontinence after menopause, don't hesitate to ask (OKC@FYZICAL.com).
-Dr. Lauren Collier Peterson, PT, DPT
FYZICAL Therapy & Balance Centers of Oklahoma City provides pelvic floor physical therapy in Lakeside, The Village, Nichols Hills and surrounding NW Oklahoma City. Our pelvic floor physical therapists are specially trained to treat all types of pelvic floor dysfunction including incontinence in men and women. Our practitioners take a patient-centered individualized approach that focuses on your pelvic health needs. If you are unsure about your pelvic health, or you want to see the FYZICAL Difference for yourself, schedule a free consultation today.