Do You Have Risk Factors For Loss of Bladder Control?
“Obesity (BMI > 25 kg/m(2)), being postmenopausal, having two or more vaginal deliveries, having a history of hysterectomy, and being a current user of hormones increased the odds of having urinary incontinence”
It is clear that being over weight puts women at greater risk for urinary incontinence. The glass half full version of this story is that women who are overweight and incontinent can, in most cases, become continent by losing weight. And not as much weight as you may think. In one study the majority of obese incontinent women who lost as little as 10% their starting body weight resolved symptoms of urinary incontinence (something to at lease consider before having surgery). What’s more, surgery for stress incontinence may be less effective among overweight women when compared to normal controls.
It seems counter intuitive that both being postmenopausal and using hormones are risk factors for having urinary incontinence. It may be that age is the real culprit when comparing premenopausal and postmenopausal women but it is certainly possible that loss of estrogen contributes to pelvic floor dysfunction as described in last weeks blog (well…go back and read it). Why then would taking hormone replacement be a risk factor? Dunno. The nice thing about no one knowing is that you are free to speculate about what might be true. Here is what I think.
After the menopause when estrogen levels drop there is a known tendency to degrade the structural collagen that supports the urethra and bladder. At the same time there is a decrease in production of a stretchy substance called elastin that keeps the vaginal tissues pliable and well… elasticy. When a women who has gone through menopause some time ago, who has lost collagen and elastin in the tissues that surround the urethra and bladder, reintroduces estrogen the tissues again become more elastic. Elastic tissues without good collagen support are less likely maintain a good urethra seal during coughing sneezing ect. What do you think? Sounds good to me.