How Hormone Changes Can Lead to Urinary Incontinence
Urinary incontinence, the loss of partial or complete bladder control, can be an embarrassing condition, and one that leads to social isolation as you avoid situations where you don’t have immediate access to a bathroom.
Stress incontinence (stress as in pressure, not emotions) is the loss of bladder control during physical activity. Any pressure applied to the abdomen and/or bladder can lead to a leakage, which may be anything from a few drops to a large, uncontrolled flow..
Stress incontinence generally occurs when you:
- Laugh
- Sneeze
- Cough
- Jump
- Exercise
- Lift heavy things
- Engage in sexual intercourse
Board-certified OB/GYN, Dr. Daniel Esteves and his expert team offer several innovative treatments for mild-to-severe urinary incontinence. He believes it’s important, too, to help his patients understand the causes and nature of their problems, so he wants to discuss how hormonal changes can lead to stress urinary incontinence (SUI).
How do hormones lead to stress urinary incontinence?
Hormones control the action of many of the body’s organs and systems, so it’s not too surprising that a change in hormones might affect the bladder and lead to urinary incontinence. Here are some of the major ways that can happen.
Nocturia
Nocturia, disruption of sleep because you have to urinate during the night, is significantly associated with testosterone deficiency (low T), lower urinary tract symptoms (LUTS), and — not surprisingly — sleep disorders. Some 1 in 3 adults over 30 experience the condition, and the risk increases as you age. LUTS is often associated with low T in elderly men, and recent studies have suggested that adding testosterone can decrease nocturia symptoms.
In hypogonadal men (those with deficient development of secondary sex characteristics due to low T), testosterone deficiency can lead to the development of nocturia, and nocturia leads to a decline in testosterone levels — a negative feedback loop.
Testosterone replacement therapy (TRT) is used to treat many hypogonadal conditions, and it represents a possible alternative treatment to the pharmaceutical options for nocturia in hypogonadal men. There have been just a few studies of the effects of TRT on nocturia in hypogonadal men, though, and more research is needed to determine how effective the treatment can be.
Prostate problems
The prostate is a male sex gland about the size of a walnut that lies just below the bladder and surrounds the urethra, the tube that drains urine from the bladder. The prostate reaches its adult size by age 20, but in half the men over age 50, it starts to grow again. One idea for this occurrence is that as you age, the prostate’s cells develop increased sensitivity to hormones in the bloodstream, fueling growth. The condition is called benign prostatic hyperplasia (BPH), and it's considered a normal part of aging.
The trouble is, the prostate can grow to be the size of an apple, and sometimes as large as a grapefruit, pushing against the urethra and lifting the bladder’s base — stressing the tissues and leading to symptoms including:
- A slow or delayed start to urination
- A poor or variable flow, the need to pee more often or wake up during the night to pee
- A sense of urgency (and not being able to hold it in sometimes)
- An incomplete emptying of the bladder
If your urinary symptoms are caused by BPH, Dr. Esteves may prescribe finasteride, a medication that blocks the effect of testosterone on the prostate. This causes the gland to shrink, reducing blockage and improving urine flow.
If you’re struggling with the symptoms of SUI, it may well be due to a change in your hormone levels. Dr. Esteves can evaluate and diagnose your condition and offer appropriate treatments to end the embarrassment and get you back on track. Give the office a call at 770-676-5878, or book your consultation online today.