After menstrual periods end, the body stops producing the female hormone estrogen. In addition to controlling menstruation and changes in the body during pregnancy, estrogen helps keep the bladder and urethral linings healthy. Postmenopausal women can experience weakened pelvic floor muscles that are responsible for bladder control, according to the medical experts at the Cleveland Clinic. This can result in bladder conditions that require medical evaluation and treatment to avoid exacerbation of symptoms.
Stress Incontinence
Stress incontinence occurs when physical activity or movement, such as sneezing, coughing or heavy lifting, places pressure or stress on the bladder. This condition is more prevalent in women than men, says Mayo Clinic, as stress from childbirth and hormonal fluctuations are significant contributors to stress incontinence. The Cleveland Clinic reports that stress incontinence is one of the most frequently encountered bladder problems in older women. Because estrogen levels decline in the postmenopausal years, the bladder is further stressed and weakened, contributing to the inability to hold urine. Having stress incontinence can cause sufferers to feel isolated and embarrassed, but it can be well managed with treatments such as medications, exercises and dietary changes.
Cystitis
Cystitis, or infection of the bladder, is caused from the introduction of bacteria into the urinary tract. This condition produces the frequent urge to urinate and causes burning and pain during urination. A decrease in estrogen production during the postmenopausal years can thin vulvar and vaginal tissues around the urethra. This can predispose women to repeated bouts of cystitis, reports The Merck Manuals Home Edition. Bladder prolapse, also common in postmenopausal women, can contribute to poor bladder emptying and the inability to flush out bacteria from the urinary tract, increasing the risk for cystitis. Although symptoms of cystitis can disappear without treatment, physicians recommend completing a course of oral antibiotics to ensure complete resolution of infection.
Bladder Prolapse
The bladder is held into place by a type of "hammock" that is comprised of ligaments and supportive muscles. When wear and tear occurs on these structures, the pelvis allows the bladder to sag or protrude through the musculature and ligaments, reports Pri-Med Patient Education Center. In extreme cases, the bladder can appear at the opening of the vagina, where it can be seen and felt. Bladder prolapse, or cystocele, is a common postmenopausal bladder complaint. After menopause, tissues of the pelvis depend upon estrogen to maintain tone, and when estrogen production declines, muscle tone declines as well. Treatment for bladder prolapse includes exercises to strengthen the muscles of the pelvic floor and the insertion of a pessary, which is a ring-like device that props up the bladder. Surgical intervention may be needed in severe cases of bladder prolapse to restore the normal anatomy of the bladder.
