Q&A: Urinary incontinence after menopause

Q: I went through menopause a long time ago, but now I'm struggling with bladder control. Is this normal?

A: Despite it being common, incontinence isn't normal. In almost all cases, it's a condition that can be treated and improved.

While you may be embarrassed, don't hesitate to tell your doctor if you're having bladder control issues. That's the first and most crucial step for getting help. Treatment will depend on the type of urinary incontinence you have and how severe the problem is.

There are three common types of urinary incontinence for women after menopause.

Stress incontinence is caused by damage to the sphincter and pelvic floor muscles. Symptoms include leakage of urine when coughing, laughing, or sneezing. Vaginal deliveries have been associated with more incontinence.

Urge incontinence is caused by an overactive muscle in the bladder. The detrusor muscle causes uninhibited bladder contractions. The most common symptom is a sense that you need to go immediately, even if you just urinated. It's often characterized by an excessive frequency of bathroom use.

Functional incontinence occurs when you are unable to get to a bathroom in time due to physical or mental conditions.

You may also suffer from a combination of these forms, which is known as mixed incontinence.

To reduce your symptoms, you'll need to make a few simple lifestyle changes. Here are some common tips your doctor may recommend:

Practice these exercises. Osteoporosis, arthritis, and general weakness from aging can make it difficult for you to make it to the bathroom quickly. Consider improving your sit-to-stand speed by practicing getting out of a chair without using your arms, walking a quarter-mile every day, taking the stairs, and doing leg raises. These simple exercises can lessen the time it takes to get to the bathroom.

Keep your bladder empty. Many women set bathroom times to help them avoid accidents. These planned trips to the bathroom help to ensure that your bladder stays empty.

Choose your drinks wisely. Stay hydrated, but be careful what you drink. Limit caffeine and alcohol, which can irritate your bladder.

Lose weight. Shedding a few pounds may help relieve some of your symptoms as it will reduce the amount of pressure on your bladder.

Your doctor may also prescribe medications. It's important to note that many urinary incontinence medications have side effects, so it may be best to speak with a specialist, such as a urogynecologist, who can tailor a program specific to your needs and symptoms. In some cases, a medical procedure may be the best choice to alleviate symptoms.

Donna Raziano, M.D., is the chief medical officer at Mercy LIFE.