Menopausal Transition Can Increase Risk of Incontinence

Dorian Martin Health Guide
  • Gotta go, but not in a good way? It turns out that incontinence may emerge as you age. And while the advertisements talk about urinary incontinence, women also are at risk of developing fecal incontinence.

    A new report from the Centers for Disease Control and Prevention looks at the prevalence of incontinence among people who are 65 years of age and above. “Incontinence presents a significant financial burden to the individual and to society,” the CDC report states, adding that the cost of bladder incontinence in 2000 was estimate to be $18.5 billion. Between 50-76 percent of these costs are comprised of resources to manage incontinence, such as absorbent pads, protection and laundry.  In addition, the average cost for fecal incontinence was estimated by the CDC to be $1,110 per individual in 2010 for those who had this type of incontinence for more than one year with at least monthly leakage of solid, liquid or mucus stool. In addition, there were additional $2,343 in costs per individual for direct medical and nonmedical expenses and $1,549 for indirect costs due to loss or productivity.

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    While the cost is important, it is also of note that urinary incontinence can be associated with other issues, such as chronic conditions such as diabetes and cancer, a stroke, cognitive impairment, mobility impairment and a urinary tract infection. There are also risk factors for bowel incontinence. These factors include chronic diarrhea, inadequate fiber, inadequate water intake, chronic constipation, diabetes, stroke, neurologic and psychiatric conditions, cognitive impairment and mobility impairment.

    It turns out that aging and menopause can be behind the development of incontinence.  For instance, the menopausal transition can cause the lining of the urethra – the tube that moves urine from the bladder in order to urinate – to thin because of decreased estrogen levels. Furthermore, the pelvic muscles also can weaken, causing women to experience urinary and fecal incontinence as they age.

    There are two primary types of urinary incontinence. The first is stress incontinence, which is the result of weak pelvic floor muscles. This type of incontinence, which is common during perimenopause, leads to leakage when you cough, laugh, sneeze or lift heavy objects. However, this type of incontinence doesn’t get worse as you go through the menopausal transition. The second type is urge incontinence, which is also known as the overactive bladder. In this type, you may have a sudden and strong urge and be unable to make it to a toilet before you urinate.

    Other types of incontinence include:

    • Overflow incontinence, in which a person has an inability to empty the bladder so she ends up frequently or constantly dribbling urine.
    • Mixed incontinence, in which a person experiences symptoms of more than one type of urinary incontinence.
    • Functional incontinence, due to a physical or mental impairment.
    • Total incontinence, in which there is continuous leaking of urine throughout the day.

    While urinary incontinence is common, it’s not something women have to endure passively.  For instance, Kegel exercises can help train and strengthen the pelvic floor muscles. Additionally, medications and surgical treatments also can treat this type of incontinence.

  • Fecal incontinence can often be prevented. To do so, you need to reduce constipation by increasing the amount of exercise you do, eating high-fiber foods and drinking plenty of fluid. Also controlling diarrhea can help. Finally, you should avoid straining when you have bowel movements because this can weaken the sphincter muscles or damage nerves.

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    If you do develop this type of incontinence, know that Kegel exercises that strengthen the pelvic floor muscles can help. Other lifestyle changes that can make a difference include: drinking at least eight glasses of water daily; consuming  fiber (fruits, vegetables, whole-grain breads and cereal) regularly; and tracking what you’re eating to see if certain foods (such as spicy foods, fatty foods, greasy foods, smoked meats, carbonated beverages, caffeinated beverages, alcohol or dairy products) are linked your fecal incontinence.


    If you experience either type of incontinence, I'd encourage you to talk to your doctor. It's not necessary to live with incontinence; treatment is available to help!


    Primary Sources for the Sharepost:

    Centers for Disease Control and Prevention. (2014). Prevalence of incontinence among older Americans.

    Mayo Clinic. (2012). Fecal incontinence.

    Mayo Clinic. (2011). Urinary incontinence.

    The North American Menopause Society. (ND). Urinary incontinence.

Published On: June 29, 2014