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Symptoms and Signs of Urologic Dysfunction After Menopause

Doctor's Notes on Urologic Dysfunction After Menopause

After menopause, a woman’s estrogen levels decrease, which is thought to contribute to urologic symptoms. Urologic conditions that can occur around the time a woman goes through menopause include bladder control problems, bladder prolapse (descent of the bladder into the vagina due to weakening of the pelvic tissues), and urinary tract infections (UTIs).

Symptoms of urinary tract infections (UTIs) include painful urination, urinary frequency or urgency, hesitant urination, lower abdominal pain, fever, cloudy and foul-smelling urine, blood in the urine, chills, nausea, vomiting, and flank pain. Symptoms of bladder control problems include stress incontinence (urine leakage occurs when a woman coughs, laughs, exercises) and urge incontinence (a strong, sudden urge to urinate which may lead to a woman wetting herself). Symptoms of bladder prolapse include pelvic pain, low back pain, difficulty urinating, stress incontinence, painful intercourse, and painful, bleeding tissue protruding from the vagina.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Urologic Dysfunction After Menopause Symptoms

Urinary tract infections

Symptoms of a lower urinary tract infection include painful, frequent, urgent, or hesitant urination; lower abdominal pain; and fever. Urine may appear cloudy and have a foul smell. Blood may be present in the urine. Painful urination is known as dysuria.

Symptoms of an upper urinary tract infection include fairly high fever (101 F), shaking chills, nausea, vomiting, and flank pain.

Bladder control problems

The most common types of bladder control problems for menopausal woman are stress incontinence and urge incontinence. Women first notice stress incontinence as the leakage of urine that occurs with an increase in intra-abdominal pressure such as that which occurs when they laugh, cough, exercise, or even stand up quickly. Urge incontinence, sometimes called irritable bladder, manifests as a strong, sudden urge to urinate. Sometimes women with this type of incontinence feel the need to urinate so urgently that they wet themselves.

Bladder prolapse

The physical problems and resulting symptoms created by a prolapsed bladder range from mild to severe according to the degree or grade of prolapse. Pelvic pain, low back pain, difficulty urinating, stress incontinence, and painful intercourse are just a few possible symptoms of prolapsed bladder. A woman with a low grade of prolapse may experience no symptoms at all. A severely prolapsed bladder can cause painful, bleeding tissue to protrude from the vagina.

Urologic Dysfunction After Menopause Causes

Urinary tract infections

Urinary tract infections are divided into two categories. A lower urinary tract infection is sometimes referred to as cystitis and involves the lining of the urethra and irritation of the bladder. An upper urinary tract infection is called pyelonephritis and involves the kidneys of the upper urinary tract.

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Illustration of the female urinary tract system

Urinary tract infections are most often caused by bacteria entering the urinary tract through poor hygiene or sexual intercourse. Low estrogen levels result in vaginal dryness and atrophy, which allow bacteria to enter the bladder, causing infection. Some researchers suggest that delayed urination and dehydration resulting in decreased urinary output may also contribute toward the development of urinary tract infections.

Bladder control problems

Bladder control problems, or urinary incontinence, occur with greater frequency in both men and women as they age. Many people aged 65 years and older experience bladder control problems that can range from a little leakage to uncontrollable wetting. The problem is more common in women than in men. Studies have suggested that a significant percentage of women older than 60 years and living at home have some form of incontinence.

Bladder control problems have many possible causes, including reduced levels of estrogen in the body. For menopausal women, contributing factors may be nerve damage from childbirth, pelvic surgery, and weakened pelvic floor muscles.

Bladder prolapse

Prolapsed bladder is a problem unique to women because of a woman's anatomy. The front wall of the vagina helps keep a woman's bladder in place. If and when the tissues of the vagina wall are weakened from the stress of childbirth, changes during menopause, or repeated physical straining due to constipation or heavy lifting, the bladder can prolapse or descend into the vagina.

10 Ways to Deal With Menopause Symptoms Slideshow

10 Ways to Deal With Menopause Symptoms Slideshow

Keep a diary to track what sets off your hot flashes. Caffeine? Alcohol? A hot room? Stress? All are common causes. When a flash starts, take slow, deep breaths, in your nose and out your mouth. For tough cases, talk to your doctor.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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