Are you waking up anxious? Trouble sleeping?? Running to the restroom constantly?? Our menopause journey comes with many unexpected symptoms. Anger can be sudden, intense and unprovoked when estrogen levels wildly swing, so much so that this is called the “rages” by some patients and clinicians. Difficulty sleeping, waking up in the middle of night and being unable to return to sleep are common complaints. So, too, are frequent tears and anxiety. It’s no wonder that menopause is often called puberty in reverse. All those emotional outbursts and symptoms that a teen experiences with puberty we also experience as our hormones drop back down. But, menopause changes far more than just our emotions.
Many women feel blindsided when they begin to experience bladder infections. If you’ve had two infections in six months or three in a year, your diagnosis is recurrent UTI, a relatively common part of genitourinary syndrome of menopause (GSM) that occurs because the urinary and vaginal biomes change as estrogen levels drop, allowing more pathogens to grow. The challenge is that many infections have become drug resistant and require more aggressive antibiotic treatment which, unfortunately, damages the biome further and creates the risk of yeast infections. If you’re in the middle of this journey, my heart goes out to you. Always ask your doctor to do urine testing to identify which bacteria you are struggling with and to identify the best antibiotics for your unique infection.
While there are many women who have all the symptoms of a UTI, sometimes no infection is actually found. Also due to GSM, the bladder, urethra, vulva and vagina become more sensitive as estrogen levels drop. That cup of coffee you may have enjoyed everyday in your 30’s and 40’s triggers symptoms in your 50’s because the vaginal and bladder wallshavethinned and become more sensitive.
The urinary symptoms of GSM aren’t always mild. For many women, they are severe and unrelenting as a constant need to urinate prevents normal sleep. In some cases, women are up hourly, running to the restroom to reduce pain. Urinary urgency often strikes, leaving you running to the bathroom suddenly. The thought of taking a long car ride is daunting as you plan restroom stops along the way and, for many, the trip just isn’t worth the stress and embarrassment. Of course, stress incontinence, that little leak that occurs after sneezing, is also quite common. With millions of women in GSM, it’s no wonder that the “pad” business is thriving.
What can you do about these symptoms? Consult with your doctor first to determine if you have an active infection. If yes, antibiotics will be the likely treatment. If infection is not present, your doctor should evaluate your genital area for telltale signs of aging and lower estrogen levels (thinning, dryness), along with an assessment of your pelvic floor muscles. Weak muscles, which often occur after childbirth, can contribute to incontinence. Tight muscles, which often occurs after injury, can cause pelvic pain and urinary symptoms. Pelvic floor physical therapy is usually recommended for both conditions. Most doctors prescribe an estrogen cream to help that skin heal and strengthen.
You could also consider using a supplement. Femetry was created by three urogynecologists who not only saw how their patients were struggling with GSM, but wanted to provide an affordable OTC option that could help. One of their motivations was the fact that many traditional medications for urinary symptoms were too expensive for patients on limited budgets. Femetry’s Bladder Flora Balance (Step #1 of Femetry’s bladder health program) is a pre- and probiotic designed to restore the urinary biome after antibiotic use and, ideally, prevent yeast infections from occurring after antibiotic use. The probiotics found in Femetry #1 have been shown to be useful specifically in menopausal women. Femetry #2, Bladder Daily Comfort, helps to calm and soothe the bladder wall and reduce the effects of stress that ideally will help you sleep better. And finally, Femetry #3 Bladder Acid Control is an acid reducer that can be used before that cup of coffee to minimize its effects.
As they say “aging is not for the faint of heart” but we can figure it out together. You are not alone.
