The years surrounding menopause can be creative and energetic. For the m ost part, our children are grown and (hopefully) out of the house, we have found fulfilling jobs and we may be able to now involve ourselves in new passions and adventures. It doesn't seem quite fair that as our spirits are soaring, our bodies can be sinking. First a few factsAs we get older, our ovaries produce less estrogen. It is this decrease in estrogen that is responsible for many of the complaints of menopause. Menopause is "officially" diagnosed when a woman has not had a period for 12 months ( if you make it 11 months and then Mother Nature arrives with her little "gift" you have to start the count down all over again!). Menopausal complaints that we often hear from our clients are
increased urinary incontinence
increased nighttime trips to the bathroom
pain with intercourse
concerns regarding bone health ( our regular readers will not be surprised when we connect bone health and urinary incontinence!)
There are of course other medical concerns related to menopause and any change in your health should be discussed with your health care provider.
What is going on? There are estrogen receptors in the walls of the vagina, the walls of the urethra and in the pelvic floor muscles. Many of the changes that occur in menopause are a result of a lack of estrogen to these organs. In a menopausal woman, the lack of estrogen causes the vaginal walls to thin and to be less lubricated. She may complain that she feels "dry" down there. She may complain of itching. Intercourse may be uncomfortable ( when it was fine before). If these changes are occurring in the vaginal tissue, then you can be pretty sure they are happening in the urethral tissue as well. A urethra that would like more estrogen tends to be irritated and urge incontinence can result.
What's a girl to do? A very common treatment for vaginal atrophy ( the medical name for the changes that occur in the vagina when there is a lack of estrogen) is supplemental vaginal estrogen. This is different from estrogen pills or patches. This estrogen is applied as a cream or a pill inserted directly into the vagina or a estrogen ring that is placed in the vagina. Your doctor or nurse practitioner can prescribe one that is right for you. The risks of this type of estrogen are different from estrogen that you take orally as a pill or a patch. Again, your health care practitioner is the best person to discuss your personal situation. Vaginal estrogen is a very common treatment and many women will notice that many of the complaints of vaginal irritation and urge incontinence will be taken care of by this type of estrogen. Give them a call and see what they say!
Urinary Incontinence All the information given in previous blogs regarding urinary incontinence can be very helpful. Maybe coffee didn't bother you in the past but your body is changing. Things that used to be OK ( coffee, artificial sweeteners, carbonated beverages and spicy and acidic foods) may be bothersome to you now. You may notice that you are going to the bathroom a little more frequently. You may be getting up more than once at night to go to the bathroom. Before menopause, we should be able to sleep through the night without getting up to go to the bathroom. After menopause, it is considered normal to get up 1 time during the night because we start making more urine at night (see, our bodies are changing!) Review the tips we have given regarding incontinence with new eyes. See if there isn't something you could be doing different.
Although there is no denying the loss of estrogen as we age, we do not have to accept the changes without a fight. There are some simple things we can do to greet this new time of our lives with enthusiasm. Check in next week for more tips on how you can give yourself a Menopause Makeover!