Navigating Urinary Health During Menopause

The menopausal transition is a significant phase in a woman’s life, bringing various hormonal and physical changes. Among these, urinary health often becomes a concern, with many women experiencing symptoms they’ve never encountered before. 

A woman's urinary health can deteriorate with menopause due to hormonal changes, particularly the decline in estrogen. This condition, termed genitourinary syndrome of menopause (GSM), affects both the vagina and the urinary system. For this discussion, we’ll focus on urinary health.

Estrogen plays a crucial role in maintaining the strength and elasticity of tissues in the urinary tract. When levels drop during menopause:

• The bladder and urethra weaken, reducing their ability to control urination.
• Tissues thin and lose elasticity, increasing susceptibility to urinary tract infections (UTIs).
• The pelvic floor weakens, sometimes leading to pelvic organ prolapse, where pelvic organs like the bladder descend into the vagina, causing incontinence or discomfort. 

Common symptoms of urinary dysfunction

• Frequent urination, including waking up at night to urinate (nocturia).
• Urinary urgency and inability to control urination (urge incontinence).
• Stress incontinence, where coughing, sneezing, or laughing causes leaks.
• Painful urination or a burning sensation.
• Recurrent UTIs with symptoms like pain, fever, and unusual-smelling or discolored urine.

Pelvic floor muscles play a crucial role in urinary health. However, different women require different approaches:

• Strengthening Exercises: Some women need to tone weak pelvic floor muscles to regain bladder control. Kegel exercises are effective for this purpose.
• Relaxation Exercises: Other women may have overly tight pelvic floor muscles and need relaxation techniques to release tension.

A pelvic physiotherapist can assess your individual needs and recommend a tailored program, which may include:

• Biofeedback Therapy: Technology to retrain pelvic floor muscles and improve bladder control.
• Electrical Stimulation: Strengthens bladder muscles to reduce incontinence.
• Vaginal Pessaries: Devices inserted into the vagina to support a prolapsed bladder.
• Surgical Interventions: In severe cases, surgery may be necessary to repair prolapse or other structural issues.

Recurrent UTIs are common during menopause due to changes in the urinary tract. Symptoms include burning sensations, urgency, and fatigue. Preventative measures include:

• Wiping front to back after using the toilet.
• Urinating before and after sex to flush bacteria.
• Staying hydrated and drinking plenty of water.
• Avoiding irritating soaps, sprays, and non-organic feminine hygiene products.

Your diet plays a critical role in urinary health, particularly during menopause. Incorporating bladder-friendly foods and avoiding irritants can significantly improve symptoms.

Foods that support urinary health

• Cranberries (contain D-mannose): Prevent bacteria from adhering to the bladder wall, reducing UTI risk.
• Probiotics: Found in yogurt, kefir, and fermented vegetables, probiotics support good bacteria in the urinary and vaginal tracts.
• Leafy Greens: Spinach and kale reduce acidity and inflammation.
• Water-Rich Fruits: Watermelon and blueberries hydrate and flush the urinary tract.
• Garlic: Boosts immunity with its antimicrobial properties.
• Omega-3-Rich Foods: Salmon and avocado reduce inflammation.
• Herbal teas like alfalfa, chamomile, marshmallow, nettle, dandelion leaf, and uva ursi  help to soothe and heal the urinary tract. 

Foods that irritate the bladder

• Caffeine and Alcohol: Increase urgency and frequency.
• Acidic Fruits: Oranges, lemons, and tomatoes can irritate the bladder.
• Artificial Sweeteners: Found in sugar-free products, these can exacerbate irritation.
• Spicy Foods and Processed Carbs: Both can inflame sensitive tissues.

Hydration tips

• Water: Staying well-hydrated is crucial for urinary health, as it flushes out bacteria and toxins. Aim for 8–10 glasses of water per day unless advised otherwise by your doctor.
• Timing: Spread your fluid intake throughout the day to prevent overwhelming the bladder. Reduce water consumption a few hours before bedtime to avoid nighttime urgency.

If symptoms persist or worsen, consult a healthcare provider. Chronic conditions like pelvic prolapse and chronic UTI require specialist care.  

The menopausal transition is a time of change, but it doesn't have to mean living with discomfort. By understanding the factors affecting your urinary health and taking proactive steps you can reclaim your confidence and wellbeing . Considering booking a consultation if you require additional help here.