One more long standing misconception about menopause may be about to be dispelled. Bladder problems like incontinence often appear in women approaching or past menopause. It has been assumed that the drop in estrogen during this time causes changes in the urinary tract organs that weaken the muscles and lead to poor bladder control.
Two separate studies published this year suggest that estrogen and menopause are not really the issue. Instead, both report attribute an increase in incontinence with weight gain in women during the menopause transition.
Dr. Elaine Waetjen and colleagues of the University of California, Davis report that “Many women and clinicians have believed urinary incontinence to be a symptom attributable to the menopausal transition, but our results suggest that the transition…has either no effect or possibly a weak positive effect on changes in the frequency of incontinence symptoms in midlife women.”
The scientists analyzed yearly data from nearly 2,500 women experiencing incontinence over a period of six years. They found that most women reported no change in their symptoms, 32% reported an improvement and only 14.7% reported worsening incontinence over the six-year time frame.
The women’s menstrual status had no association to the changes in incontinence. Changes in weight, however, did matter. As women reported an increase in weight gain, their incontinence worsened.
Another study by researchers at the University of Pennsylvania, in Philadelphia confirmed this finding. These scientists measured the estrogen levels of 300 perimenopausal or menopausal women over time and compared estrogen status to reported complaints of urinary incontinence. They found no association between lower estrogen and urinary incontinence. In fact, urinary incontinence issues actually improved during the time when the women’s estrogen levels plummeted. However, women who were overweight (a high body mass index) had significantly higher urinary incontinence scores than women in the normal weight range.
Both reports suggest that weight control during menopause is much more important for maintaining healthy control of the bladder and urination than worrying about estrogen declines.
Article Links:
Reuters Health article, 2008. “Worsening Incontinence not Linked to Menopause”
http://www.reuters.com/article/healthNews/idUSCOL75650520080327
Waetjen, E., et al., 2008. “Factors Associated with Worsening and Improving Urinary Incontinence Across the Menopausal Transition,” http://www.greenjournal.org/cgi/content/abstract/111/3/667?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=incontinence&searchid=1&FIRSTINDEX=0&volume=111&issue=3&resourcetype=HWCIT
Related Article Links:
Web MD Article, “Menopause and Bladder Control Problems,”
http://www.webmd.com/urinary-incontinence-oab/womens-guide/bladder-control-menopause
Sullivan, N., 2004. “Ask an Expert: Menopause and Incontinence”—good description of Kegel Exercises
http://www.providence.org/oregon/Health_Information/Ask_Menopause_incont.htm