We have come a long way in recent years in understanding just how many physiological changes are related to the menopause. Of these changes, perhaps the most personal, and unreported symptoms relate to the genital and urinary tract.
It is estimated that 70% of perimenopausal women will experience vaginal discomfort of some kind, and around 50% of women experience changes in their bladder function. Of these women, it is thought that only 1 in 6 ever report this bladder dysfunction to a healthcare professional. This would suggest that the majority of all perimenopausal women have vaginal and/or bladder symptoms which remain unreported and potentially untreated.
The changes in bladder function we most commonly see around this time relate to the ability to hold urine. This includes; a sense of urgency to pass urine, an inability to hold urine during urgency, an inability to control urine during exertion (such as laughing or coughing) and increased frequency of urination. Other bladder-related symptoms include; cystitis, urinary tract infection, pelvic organ prolapse.
Read about the different types of urinary incontinence here.
These symptoms emerge around the time of the menopause because of the drop in oestrogen. The skin and tissues in our bladders and pelvic floor have oestrogen receptors, which means that when the oestrogen levels drop, their function is affected. It is important to understand that, while some symptoms of the menopause will pass – for example hot flushes last an average of 7 years, vaginal symptoms will not improve unless treated.
The good news is that the vast majority of these symptoms are easily treatable with non-invasive treatment options. A range of treatment options, including pelvic floor training, behaviour modification and/or HRT may be suggested based on the symptoms experienced. For example, 70% of women experiencing leaking during exertion will resolve their symptoms with pelvic floor retraining alone.
So, what can you do if you are experiencing these symptoms? Specialist GPs, Specialist Nurses and Women’s Health Physiotherapists are all healthcare professionals trained in assessing and treating these symptoms.