What Women Should Know About Their Urologic Health as They Age
Middle age is a time of great change for women, both in their personal lives and in their bodies. Many women begin to shift their focus from balancing work and raising a family to focusing more on their work lives and planning for how to spend the next 25 years. At the same time, their bodies are also going through changes. The most obvious is menopause. But during these years, women also face a greater risk of developing high blood pressure and diabetes. All of these changes can increase a woman’s chance for having urologic health issues. These include kidney and bladder problems such as urinary tract infections, incontinence, kidney stones and even kidney disease.
Urinary Tract Infections
Urinary tract infections (UTI) are common in women. They account for more than six million visits to doctors’ offices per year in the United States. While women can have a UTI at any age, women often get UTIs after menopause. “When women go through menopause, they have less estrogen. This causes changes in the urinary tract and raises their risk of UTIs,” explains Lara MacLachlan, MD, urologist at Lahey Hospital and Medical Center in Burlington, MA. “This lack of estrogen allows the bad bacteria to overgrow and overpower our good bacteria, which makes women more likely to get UTIs.”
Other risk factors for UTIs include:
Having kidney or bladder stones, which can hide the bacteria that causes infection.
Diabetes, which can cause the bladder muscle to weaken and lead to UTIs.
Not fully emptying the bladder.
Drinking plenty of liquids, especially water, may cut down on your chance for getting a UTI. Many women believe drinking cranberry juice will lower their chance of UTIs. “Unfortunately, there’s only mediocre evidence for this,” Dr. MacLachlan notes. “Many women also drink cranberry juice cocktail thinking it will help. But it doesn’t have enough real cranberry juice in it to make any difference,” she adds.
For post-menopausal women with repeat UTIs (two or more infections within a six-month period), the problem can often be treated with topical estrogen cream.
Urine leakage is a problem for millions of American women. There are two main types of incontinence:
Stress incontinence (leaking urine when you cough, laugh, sneeze, lift something heavy, or exercise); and
Overactive bladder (when you start leaking urine before you can make it to the bathroom).
Younger women tend to get stress incontinence, which is more common after childbirth. As women enter their 60s, their risk of overactive bladder increases. As with UTIs, menopause may play a role, Dr. MacLachlan notes. “The lack of estrogen in the tissues that support the urinary tract may contribute to a woman’s incontinence,” she says.
There are several lifestyle changes that can help with incontinence. They include:
Reducing food and drink that irritate your bladder, especially caffeine products.
Going to the bathroom at timed breaks, such as every two to three hours.
Learning how to do Kegel exercises to build pelvic floor muscle strength. This helps hold urine inside the bladder and prevent leaks.
Quitting smoking. Chronic coughing caused by smoking can put pressure on the pelvic floor muscles and cause urine to leak.
Losing weight. Extra weight increases pressure on your bladder and pelvic floor muscles. This weakens them and allows urine to leak out when you cough or sneeze.
If these lifestyle changes don’t help enough, talk to your healthcare provider about your leakage. Depending on the kind of incontinence you have, there are other treatments that can help. For Stress Urinary Incontinence (SUI), several different surgeries can help.
To treat Overactive Bladder (OAB), there are a number of drug options. If drugs don’t work, your doctor may recommend onabotulinumtoxinA (Botox®) injections into the bladder, a “bladder pacemaker” or nerve stimulation.
Men are more likely than women to have kidney stones. Yet, the number of women with stones has increased in the past 10 years. This may be connected to the rise in obesity in women compared to men (obesity is a known risk factor for kidney stones).
Kidney stones tend to develop in midlife. They develop in the urinary tract, and can grow and change location within the kidney. Stones often begin causing symptoms when they block urine flow from the kidney to the bladder. This is often very painful.
A person who has had a kidney stone also has a 50 percent chance of getting another one. The best way to avoid getting another stone is by drinking plenty of fluids. If you have had kidney stones, you should:
Drink 10 10-ounce glasses per day of any liquid.
Reduce sodium in your diet. More sodium increases calcium levels in the urine, which can raise the risk of stones forming.
Eat plenty of fruits and vegetables.
Have three to four servings of calcium-rich products a day. Even though calcium in your urine increases your risk of getting stones, calcium in your diet can protect against stones.
As women reach their 50s and 60s, their risk of kidney disease increases, explains Janice Zaleskas, MD, a kidney specialist at Lahey Hospital and Medical Center. “Kidney disease becomes more common as women age. This is because conditions such as high blood pressure and diabetes, which affect the kidneys, also become more common,” she says. Dr. Zaleskas notes that more women are living with kidney disease.
The kidneys remove waste and extra fluid from the blood. In a person with kidney disease, the kidneys don’t work as well as they should, and may even stop working altogether. Kidney disease is called a ‘silent disease’ as there are often no warning signs. Kidney disease can be very dangerous if it is not treated.
The best way to keep the kidneys in good shape as you age is to live a healthy lifestyle. Eat a healthy diet and exercise. Both can help prevent kidney disease and the major risk factors that lead to it. Eating a low-sodium diet and getting exercise will make a difference. “Any exercise that raises your heart rate is good,” Dr. Zaleskas says. For women with kidney disease, weight-bearing exercise such as walking is very good for keeping bones strong. That’s important because women with kidney disease are at an even greater risk of osteoporosis (bone weakening) than other women who have gone through menopause. Remember, kidney disease can be serious, but early detection and proper treatment can increase the life of your kidneys.
Read the latest issue of Urology Health extra, the Urology Care Foundations patient-focused magazine.