Every now and then, a question from a patient or website visitor tells me that bladder function is interfering with a woman’s sexuality. Maybe their “urge to go” makes them lose focus during an intimate moment, or maybe symptoms are making them feel less than sexy.
In addition to being located in a very neighborly way, the base of the bladder and urethra and the vagina also have the same embryonic origin. They both have estrogen receptors, which means that they’re both affected by changes in hormone levels. And sometimes, I know, when you experience discomfort, it can be a little hard to pinpoint exactly what’s happening where “down there.”
So let’s review a couple of common problems.
Twenty to thirty percent of us will have a bladder infection at some point in our lives. That’s the most common form of urinary tract infection (UTI), which also includes the kidneys and urethra.
A bladder infection is often the result of bacteria that has made its way into the organ, usually from the vagina or anus—again, that neighborliness. (Remember to wipe from front to back.) Symptoms include:
- Pain or burning during urination
- Urgent need to urinate immediately
- Need to urinate extremely frequently
- Passage of small amounts of urine at a time
- Pain in the abdomen or lower back
- Need to get up from sleep to urinate
- Cloudy, bloody or bad-smelling urine
If you are experiencing any of these symptoms, see your doctor right away. A bladder infection is easily treatable with medication, but you’ll also want to make sure it’s not a sign of something more serious, like vulvovaginal atrophy or kidney problems.
Overactive bladder (OAB) occurs when the muscles of the bladder involuntarily contract, making the urge to urinate more frequent than normal. There’s a dry and wet version: If you can make it to the bathroom in time, that’s dry (or stress incontinence); if you have any leakage, that’s wet (or urge incontinence).
Watch your weight to make OAB less likely to occur; being in the top third of body mass index range increases your risk. You can also take these steps to eliminate or prevent OAB:
- Do Kegel exercises, which, because of that neighborliness, are good for both urination and sex!
- Limit your fluid intake before bedtime
- Go to the bathroom twice before bedtime
- Avoid caffeine, alcohol, citrus juices, and carbonated beverages
- Avoid spicy and acidic foods
Other urinary problems, including incontinence, are not uncommon in post-menopausal women and are often a result of declining muscle tone in the pelvic floor—again, that estrogen effect. Kegel exercises can help keep our organs in place and functioning well; localized estrogen may also be something you want to consider. But if you’re experiencing any kind of bladder issues, be sure to talk with your doctor about it. Just because these conditions are predicted for our age group doesn’t mean you have to put up with them.
Paying attention to your body is the first step to good health, but don’t neglect the second: Seeking help when something’s not right.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.