Perimenopause and Your Urologic Health: What to Expect and When to Talk to Your Physician
During perimenopause, estrogen levels slowly decrease, causing changes to your urologic health.
These symptoms can range from mildly bothersome to distressing. Fortunately, your doctor can suggest lifestyle changes or prescribe medicine to reduce discomfort.
What is Perimenopause?
Perimenopause, a transitional period before menopause, can last from a few months to eight years. For some women, perimenopause begins in their mid-30s. For others, it doesn’t start until their 50s. For most women, it begins between 40 and 44. During perimenopause, your menstrual cycle becomes unpredictable. In addition to urologic problems, you may have mood changes, trouble concentrating, night sweats, headaches, hot flashes, vaginal dryness, sleep disruption, and PMS-like symptoms.
Are Urological Changes Common During Perimenopause?
Urological changes are common in perimenopausal women. Women in early perimenopause and late perimenopause are 1.34 times and 1.52 times more likely to suffer from urinary incontinence than premenopausal women.
What Causes These Changes?
Estrogen is a sex hormone that maintains your uterine lining, increases sexual desire, and keeps your vagina lubricated and its walls thick. It affects the health of your heart and blood vessels, bones, skin, hair, breasts, and even cognitive function. Estrogen also plays a role in urinary function. It maintains your urethra and pelvic floor muscles, which support your bladder. When your estrogen levels decrease during perimenopause, your urinary tissues don’t function as well, and your bladder may weaken.
These are some of the urologic changes you can expect in perimenopause:
Overactive Bladder
When your bladder is weaker, you have less control of it. That can result in an overactive bladder (OAB). OAB usually causes increased urgency to pee and more frequent visits to the bathroom.
Stress Incontinence
Thinner, weaker pelvic floor muscles can make you more likely to leak urine if you cough, sneeze, laugh, exercise, or lift heavy objects.
Bladder Prolapse
Reduced estrogen in perimenopause weakens the connective tissues that support your bladder, which can cause the organ to prolapse or drop out of place. When this occurs, you are more likely to suffer from OAB and may also have difficulty urinating or experience urine leakage.
Frequent Bladder Infections
Estrogen supports the Urobiome, the “good” microbiome of the urinary tract that helps prevent urinary tract infections (UTIs). Weakened urinary walls from estrogen fluctuation make it easier for “bad” bacteria to penetrate your urinary tissue. As a result, you may suffer from more frequent UTIs.
When to See a Urologist
Although OAB, frequent UTIs, and bladder prolapse are common during perimenopause and menopause, you don’t have to accept these conditions if they cause discomfort or distress. These are signs it’s time to make an appointment with a urologist:
Persistent lower back pain may indicate you have a UTI that reached your kidneys
Urine leakage or more urgent or frequent urination
Two or more UTI infections within six months or three in a year
Pelvic or lower back discomfort or pain can be from bladder prolapse
How Can a Urologist Help?
A urologist can develop a treatment plan to address perimenopausal changes to your urologic health. It may include:
Prescription medication for OAB
Topical estrogen to relieve symptoms of OAB and stress incontinence and reduce the frequency of recurrent UTIs
Exercises to strengthen your pelvic floor, such as Kegels or yoga
Drinking fewer beverages that can irritate your bladder, such as caffeine and alcohol
Surgery to repair pelvic organ prolapse
Help for Perimenopausal Changes to Your Urologic Health
You don’t have to accept distressing perimenopausal changes to your urologic health. The compassionate physicians at Norman Urology Associates are excellent listeners and highly skilled specialists. Learn more about our practice. Let us know how we can help.