A.Vogel’s Menopause Flash: Common bladder problems and infections

Hello and welcome to another edition of A.Vogel’s Menopause Flash. Today I’m going to be talking about bladder health during menopause. Bladder problems are very, very common not just during menopause, but before and after it too. And they come with many potential symptoms and different causes, which makes the whole thing quite complex. So I’m just going to look at a couple of them, and explain why they happen and what you can do about them.

Menopause | Healthy Ageing

Mackie Vadacchino

22 January 2018

Weak Bladder

One of the main issues is a weak bladder. You may find that you start needing to pee more. For the first time in your life, you might find yourself getting up in the middle of the night or experiencing leakage when you laugh, run or jump.

One reason this can happen is that, as you go through menopause, your estrogen starts to fall. And this fall in estrogen can affect the strength of the bladder valve: it gets a little bit weaker and because of that, the bladder can’t hold as much urine, and that’s what makes you need to pee more.

What can also contribute to the problem is something we all have, the pelvic girdle muscles. They’re a bit like a hammock that’s slung across the inside of the hip bones: they support your bladder, uterus and intestine. During menopause, especially if you’ve had children, these muscles can get a little bit weak and drop a little. This can be enough to slightly shift the bladder, which can make it more sensitive and trigger the need to go a little more often.

So what can you do to alleviate these particular symptoms?

Believe it or not, one of the most important things you can do is drink more water. I know, this is fairly counterintuitive, but if your bladder valve is already a little weak and you don’t drink enough water, then over time your urine gets more acidic and more concentrated, which will then irritate the already weak bladder valve, which in turn can make you want to go to the toilet a lot more.

The other thing you can look at is phytoestrogen supplements, such as our Menopause Support, because they can gently help to raise estrogen levels, which may help strengthen the valve. The other thing, which is really important for keeping all these organs in place and strengthening the pelvic girdle muscles, is called Kegel exercises. These are simple little exercises that you can do every day while you’re brushing your teeth or waiting for the bus or waiting for the kettle to boil. All you need to do is Google “Kegel exercises” and the instructions will pop up. And it’s really important to do these on a daily basis if you can.

Bladder Infections and Cystitis

The other main bladder-related problems during menopause are bladder infections, also known as cystitis. I first got cystitis when I started menopause and I was rather surprised by it. You may also find yourself with repeated bladder infections, or that your bladder gets really sore. You may also get cystitis-like symptoms, but when you go to the doctor, there isn’t  any infection present.

This is quite complicated so bear with me. When you go through menopause, falling estrogen will affect the production of a slightly acidic vaginal mucous that helps promote friendly bacteria “down there.” We have friendly bacteria in the vagina and in the digestive system, and the ones in the vagina help to keep everything in balance. But because the opening of the vagina and the entrance to the urethra—that’s the tube that leads from the bladder—are very close together, you can get cross infections going on. So the friendly bacteria in the vagina  work at guarding the opening of the urethra as well. If the number of good bacteria in the vagina starts to fall, the bladder will become much more vulnerable to infections.

The problem is that when you go to the doctor with cystitis, you will more than likely get antibiotics, and those antibiotics will kill off more of the friendly vaginal bacteria and you’ll end up in a vicious circle of repeated infections. You get more antibiotics, you get another infection—this cycle can go on for ages and won’t clear up at all.

Have you ever heard of something called “honeymoon cystitis”? Well, it can happen during menopause too. A lot of women still enjoy a very healthy sex life, but because the friendly vaginal bacteria population is smaller, there’s more opportunity for infection and a greater likelihood of irritation. Purely because the vagina walls can get a lot thinner and a lot more vulnerable to stress as well.


Another potential cause is dehydration. As I mentioned before, dehydration can irritate the opening of the bladder valve, and if that goes on for too long, it can get so irritated and inflamed that it ends up causing cystitis-like symptoms. I’ve had it once, it’s horrible. I won’t go into details, but I ended up very, very dehydrated and my bladder just went into meltdown. And the problem is that when something like this happens during menopause, it’s very difficult for the bladder to bounce back like it would have before.
Now I find that if I go only one day without drinking enough water, my bladder will let me know, and it usually happens at around three in the morning. So drinking water is really, really important.

What can you do to help?

In this particular situation, where they may or may not be an infection, start by going to see your doctor. If you have a persistent infection, consider our Bladder Formula – Cystoforce, which has been licensed for relieving the symptoms of cystitis.

The other thing that could be really good for keeping the bladder in tip-top shape is cranberry. We know that it can help to keep the bladder wall healthy, but it can also stop bad bacteria from sticking to it. Cranberry is nice to use on an ongoing basis preventively and to support the bladder. It’s important to look for sugar-free cranberry juice—avoid the “cranberry cocktails” that are often more sugar than juice.

The other thing you need to do, especially if you’ve been taking antibiotics, is to get a good probiotic, specifically one recommended for the vagina.

You should also look at your soaps, shower gels, bath bombs and your underwear. Why? A decline in the number of friendly bacteria in the vaginal area can weaken their ability to protect you and the whole area can become much more sensitive to chemicals. A lot of the shower gels and things we use are packed with chemicals and chemical cocktails, which can irritate the whole area.

A few more things to keep in mind

To keep this whole area nice and healthy, you need good air flow down there. Wearing underwear, pants and tights made of man-made fibres can also contribute to the problem. Wear cotton pants if you can, because doing so can make quite a difference.

And one more thing: If you spot blood in your urine, if you feel that you’re running a temperature or you really don’t feel well, it’s very important to go and get checked out by your doctor before you start treating it naturally.

I hope you’ll take advantage of this food for thought. Stay healthy!

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