Around 1 in 3 women leak urine when they cough, sneeze or jump, this is called urinary stress incontinence but this isn’t the only bladder issue that can affect women, especially around the menopause. An overactive bladder is also a common complaint. It can often be in addition to bladder leaks too which can make life pretty miserable. So what is an overactive bladder, how does it affect you and as a menopausal runner, what can you do about it?
What is an overactive bladder?
If you find you need to pee far more often than your friends, sometimes have to get to the toilet really quickly and a few minutes after you’ve gone, you need to go again, then you might have an overactive bladder. If you’re the person reaching the front of the portaloo queue before your race and immediately going straight to the back of the queue to line up again, then read on.
Women often say they have a ‘small bladder’ and that’s certainly how it can feel. In reality, the bladder is usually of a normal size but the muscular wall just contracts more frequently than it should.
The average person passes urine six or seven times in 24 hours.
What causes an overactive bladder?
There isn’t usually one clear reason why a bladder behaves like this and an overactive bladder is often due to a combination of factors. These are some of the reasons why your bladder might contract inappropriately:
- Your urine is too concentrated. It’s tempting to restrict your fluid intake if you have an irritable bladder. You would think that drinking less would mean you need to go to the loo less but the converse is true, drinking less makes your urine more concentrated and that can irritate the bladder and you need to pee more.
- Your oestrogen levels are low. Declining oestrogen levels in peri and post menopause can cause bladder muscle irritability. They also cause atrophy (thinning) of the tissues around the urethra (tube from bladder to the outside) and vagina which can contribute to needing to pass urine a lot.
- Irritants are affecting your bladder. Caffeine and alcohol are known to irritate the bladder. And women in perimenopause often find they have an increased sensitivity to both of these. Combine these with low fluid intake and concentrated urine and it’s a recipe for urinary disaster.
- You’re constipated. Being bunged up in your bowel is never a good thing for your bladder health. Straining on the loo weakens your pelvic floor and having bulky faeces in your lower bowel presses on your bladder making you need to pee more often and obstructing the flow of urine so your bladder doesn’t fully empty.
- You have a urine infection. If frequency is something new for you, don’t just assume it’s an overactive bladder. It can also be a sign of a urinary tract infection. It’s usually, but not always associated with stinging or burning when you wee, lower abdominal pain and feeling unwell.
- There’s something else going on. Certain medical conditions can give you symptoms of an overactive bladder. These include diabetes, neurological conditions and bladder tumours. Some medications can make you need to go for a wee a lot too including diuretics (often known as water tablets).
Be aware that around 15 per cent of men also have an overactive bladder. They’re often more reluctant to seek help than women. They have additional reasons that might be underlying the urinary frequency including prostate enlargement and disease.
How can you treat an overactive bladder?
As usual, it’s good to control the controllables and do what you can to help yourself. Looking at the list above it’s easy to see that drinking plenty of fluids and avoiding caffeine and alcohol might help. Avoiding constipation by running regularly and making sure you eat plenty of fibre alongside increasing fluid intake is something we can all do too.
It might help to know that using relaxation and distraction techniques before your race can help. Nerves and thinking about needing to wee will almost certainly make your symptoms worse.
It’s time to visit the doctor if you think you might have an infection (take a sterile, mid flow sample of urine with you) or if there could be another underlying reason for your symptoms. For example, you might be prescribed vaginal oestrogen if vaginal atrophy is thought to be the cause. You might also be referred for further tests.
If it turns out to be pure overactive bladder, then more help is at hand. Certain medications can be used to relax the bladder; they do have side effects but can be very helpful for some people. With guidance it’s possible to retrain your bladder to tolerate larger volumes of urine. Bladder botox injections are used by some specialists for short term relief and in extreme situations, nerve stimulation and bladder surgery may also be offered.
Don’t let an overactive bladder stop you being able to exercise, it’s a really important time of life to be more active than ever.
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Featured image: summa at Pixabay
