Menopause & Incontinence
During and after menopause, estrogen levels naturally decline. Vaginal tissue, including that of the bladder and urethra (the tube from which urine leaves the body) require estrogen to stay strong and elastic. As estrogen levels drop during menopause, these tissues thin and weaken, giving you less control.
Problems that may develop because of changes due to menopause:
Stress incontinence. As estrogen levels naturally decline during menopause, sphincter, urethra and pelvic tissues weaken. This change can make it more difficult to hold urine, resulting in leakage when pressure is exerted on the bladder (such as pressure caused by coughing, sneezing or lifting). It’s one of the most common kinds of bladder leakage in women.
Urge incontinence. As estrogen levels naturally decline during menopause, sphincter, urethra and pelvic tissues weaken. The bladder has a more difficult time stretching to accommodate filling. As the bladder fills, loss of stretch causes irritation, resulting in more frequent urges to go.
Nocturia. A need to wake several times at night to urinate.
Bowel incontinence 101
Bowel incontinence, also referred to as Fecal incontinence or Accidental bowel leakage, is the inability to control bowel movements resulting in an unexpected leakage of stool. Leakage may occur in small amounts consisting of mucus and liquid stool, or more frequently consisting of solid stool. It may be experienced with symptoms such as an urgent need to have a bowel movement, spotting of stool, diarrhea, or constipation. There are two common types of bowel leakage:
- Urge Bowel Incontinence – you experience a sudden urge to have a bowel movement, but cannot make it to the bathroom in time
- Passive Bowel Incontinence – nothing is felt to indicate that a bowel movement is going to occur.
Though it can be embarrassing, it is important to remember that bowel leakage is common and manageable. Approximately 18 million adults – 9% of women and 8% of men experience it in some form. The incidence of bowel leakage increases with age.
Many people resort to altering their lives to cope with bowel leakage, but it could be as easy as finding the right undergarment to help manage the condition and give your confidence a boost. Find what works best for you.
As every person’s body is different, talking to your doctor about your specific symptoms offers the best chance of managing, reducing or even eliminating leaks.
Risk factors for bowel leakage
Muscles and nerves of the rectum and anus must work together to hold stool, signal when it’s full, and release the stool. There are many reasons why this may not happen. Some of the most common reasons include:
- Chronic constipation (causes the muscles of the anus to stretch and weaken)
- Constipation due to “overflow” that can occur when stool becomes backed up and unformed stool leaks around the blockage
- Diarrhea as a result of Irritable Bowel Syndrome (IBS), Irritable Bowel Disease (IBD), diet, drugs, etc.
- Neurological disability or nerve disorders (e.g. Multiple Sclerosis, stroke, spinal cord injury, etc.)
- Cognitive impairment
- Obstetric abnormalities
- Colo-rectal injury and surgery
Irritable bowel syndrome (IBS) vs. bowel incontinence
Irritable bowel syndrome is a gastrointestinal disorder resulting in symptoms including abdominal pain, diarrhea or constipation, bloating, bowel urgency, the feeling of incomplete evacuation of stool after a bowel movement, and bowel incontinence.¹
Between 10–15% of Americans experience irritable bowel syndrome, many of whom experience bowel incontinence as a result.² There are a variety of treatment options for IBS that help improve individual symptoms. Talk to your doctor if you have symptoms of IBS such as bowel incontinence.
1. Irritable Bowel Syndrome. (n.d.). Retrieved February 2016 from http://uclacns.org/patients/disease-information/irritable-bowel-syndrome-ibs/
2. Wald, Arnold M.D. Clinical Manifestations and Diagnosis of Irritable Bowel Syndrome in Adults. (2014, November 14). Retrieved from http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-irritable-bowel-syndrome-in-adults
Products for bowel incontinence
Depend® offers a range of products and absorbency levels depending on the amount of leakage you experience. For light to moderate amount of leakage, choose Depend® FIT-FLEX Underwear with maximum absorbency and worry-free odour control. But for considerable and higher amounts of leakage, Depend® Adjustable Underwear is a more suitable option. It is designed to be changed two ways: stepping in and out of it like regular underwear, or opening the side perforations for easy changing without having to remove pants and shoes.
Products for IBS
For mild IBS Depend® FIT-FLEX® Underwear or any Silhouette® Briefs with maximum absorbency will offer good balance of protection and comfort in a pull-on style, just like regular underwear. For considerable and higher amount of leakage, Depend® Protection with Tabs offers maximum absorbency with side barriers to protect against leakage and four refastenable tabs for discreet, easy removal.
How to talk to your doctor about incontinence
Since every person’s body is different, getting advice specific to yours offers the best chance of managing, reducing or even eliminating leaks. Remember, bladder and bowel leakage are symptoms that are not new to your doctor. To make the conversation easier, write down and share the following things:
- When you leak,
- How often you leak,
- How much you leak,
- Any triggers or activities that cause you to leak,
- Why you feel this is bothersome.
How to talk to your family about incontinence
Consider recruiting the emotional support of your family and sharing what you are doing about your symptoms and what you have learned. Their empathy and support will help you be more empowered, proactive and prevent the tendency to develop coping behaviours that may not be in your best wellness interest or theirs.
The more you know about incontinence, the more you can live your life and not your condition. Here are some online sources and organizations to learn more:
WebMD.com. The leading online source for trustworthy and timely health and medical news and information.
MayoClinic.org. The online site for one of the most highly respected medical practices in the world.