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Problems affecting the bladder and vagina are extremely common in post menopausal women. One research paper stated 'that by 15 - 20 years after the menopause each woman would have a urinary or vaginal problem or possibly both.' Unfortunately many women experience problems in these areas within a very short period of time. Some women are aware of vaginal and/or bladder symptoms even before their periods have ceased, whilst for others these problems arise within a few months or years of their menopause.
The nature of the problems seen, typically bring about a reduction in the quality of life for the woman. The severity of these problems may often be marked causing the sufferer distress, with consequent repercussions for those closest to her.
Although these problems are both common and distressing it is worth remembering that the availability of therapies to alleviate the symptoms is limited. That by the time the problem is established treatment regimens are only addressing individual symptoms rather than affecting a 'cure.' Prevention, if possible, is by far the best approach to dealing with the potential range of urinary and vaginal symptoms that can follow the menopause.
The reason by which similar problems arise in both the vagina and bladder of post menopausal women, is due to the fact that when we are developing in our mothers womb, the tissues of both the vagina and lower portion of the urinary tract, are derived from the same cells. These cells respond positively to the presence of oestrogen in that they are maintained in a healthy condition, whilst the opposite is seen, i.e. the cells deteriorate when oestrogen is no longer present, which is of course a normal sequence of events once we become menopausal. Even with the less dramatic hormonal changes seen throughout each menstrual cycle, many individuals may become aware of symptoms, especially urinary ones, at certain times of the month.
Typically a deterioration in urinary tissues due to oestrogen deficiency, will cause a woman to present with a number of symptoms. These symptoms generally reflect an irritative response of the less than healthy tissues to the presence of urine. Women generally complain of the need to pass urine more frequently, and may even say that they now need to get up in the night to pass urine. When they need to pass urine it is often with a great sense of urgency. They may also complain of discomfort on passing urine. Common adjectives used to describe this discomfort are that the urine burns or stings.
These symptoms are also those experienced if you have a urinary infection. Indeed urinary infections are more common in urinary tissue that is not as healthy as it once was. It is important therefore that the presence of any infection is eliminated by appropriate investigations.
Many women also suffer from stress incontinence, when they find that they dribble some urine if they cough, sneeze or laugh. Although this problem is not thought to be caused by being menopausal, the state of being oestrogen deficient does exacerbate these sort of problems.
In one study of women attending a menopause clinic, 20% of women complained of severe urgency and 50% of them of stress incontinence.
The deterioration seen in vaginal tissues as a result of oestrogen deficiency, being menopausal, may bring about a variety of symptoms of vaginal discomfort such as sensations of a burning nature, dryness, soreness, itching, recurrent infections such as thrush, and pain during sexual intercourse. Some women present with bleeding which may occur with sexual intercourse or whilst having a routine cervical smear taken or indeed for no apparent reason at all.
The prevalence of these symptoms in post menopausal women is high. A survey of 61year olds found that 35% of them experienced vaginal symptoms.
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