Low oestrogen and bladder urgency

Submitted by louiseds on November 8, 2012 - 8:30pm
Body: 

HI All

Long story. Went for a PAP smear yesterday. Followup on an earlier one that was too dry to get a decent sample of cells. Had to use Vagifem for 2 weeks to build up the cells of my cervix so they could get a better sample. I managed to get 10 days of Vagifem and the doctor said it was still a bit dry. Ho-hum. Here's hoping it will be satisfactory this time. I don't want to use Vagifem again. The discharge made my pubic hair stick to my knickers (ouch!) and I kept getting hot flushes during the day. None yesterday or today, so far. Last Vagifem was late the night before last. Who says it only acts locally? Bah. Humbug.

I asked my doctor about the role of using vaginal oestrogen in general. She said that when the body is low in oestrogen, ie full lactation and menopause, oestrogen not only makes the vaginal ephithelial cells in a mature state and the same in the lining of the urethra, it also has a role in keeping the inside of the bladder walls happy. When oestrogen is low the bladder gets irritable *(maybe because there is less lining between the urine and the nerve endings behind the wall?) so we are extra sensitive to urge sensations. Perhaps the 'let's empty the bladder now' signals get amplified too?

This would explain both the postpartum, menstrual and menopausal frequent urges to urinate. I think the trick is to teach the brain not to be so darned sensitive to these signals, ie quickly and consciously turn them off if you know that your bladder is not full yet. With all the oestrogen changes that happen in a woman's lifetime it is easy to see how the signals can get confused.

Hope that bit of info produces an Aha! moment for you, and you can stop feeling bad about a few drops escaping, and get on with re-educating your over-sensitive brain to behave itself and not over-react to the slightest stimulus.

Louise

Forum:

Surviving60

November 9, 2012 - 7:56am

Yes, I think you are onto something, Louise. So, so many of these complaints come from those very populations that you identify - all of them affected by low estrogen. Patience, understanding, attitude, POSTURE to keep the wrong kind of pressure on the organs (whether one has prolapse or not!), constant care to empty fully, and maintaining a healthy balance in all areas of life......should get most of us through. I'm lucky not to be plagued with this issue (so far) but I view my posture and lifestyle measures as preventative. - Surviving

fab

November 9, 2012 - 10:37pm

I am not sure that the occurrence of low oestrogen is the full explanation for frequent urges to urinate during pregnancy, postpartum, menstrual cycle or menopause. If this were true then every woman, or at least 75% of women would experience this, but I don’t know if that is the case.

And the question remains, what levels of low oestrogen are we talking about; I would image there would be a wide fluctuation amongst women even during these singular times.

Besides this, there are a number of other factors which can also cause the frequent need to urinate. Just the straightforward uterine prolapse itself is widely known to create a frequent need to urinate, as are malfunctioning bladder nerves, and urinary tract infections to name a few.

It is true that low oestrogen leads to a thinning and drying of vaginal and urinary tissues at menopause. (And note this is at menopause and does not necessarily apply to other times.) Whether, this also affects the bladder, as your doctor says, is quite possible. What it is that we can take away from that would depend of course on what she meant by irritable. Does she mean that the bladder has aged, and is therefore less tolerant to fullness, or less able to tolerate holding urine for long periods, or that the bladder reacts more sensitively to the acidity of the urine itself? Or, did she mean that with less oestrogen to cause retention of water and sodium, the bladder has become alarmingly efficient? Or possibly, that with age the surrounding muscles and sphincters have relaxed?

In any case, this would give me more reason to understand why some women become so desperate for relief.

I am not sure about your reasoning behind signals being confused.

In my personal experience, bouts of frequent urge to urinate involved a significant amount of urine and no incontinence. Quite unlike stress incontinence which involves involuntary drips on your panties.

But then here again, you see, I have difficulty in just relying on a belief of mind over matter to get one through; for stress incontinence can also have any number of causes including nerve pathology, growths in the abdominal region, urinary tract infection, uterine fibroids or possibly a tumour in the bladder.