Healthy Bladder Series: Hormone Check Up

It was an accidental finding.

A few months ago, I uncovered an issue I didn’t realize I had until it improved.

During the transition to Menopause, I started having significant issues with getting deep sleep.

I was stuck in this cycle of poor sleep leading to increased anxiety and a harder time managing stressors that went round and round despite my best efforts.

It was impacting my health and performance.

I’d been taking Melatonin for almost a year which had helped tremendously but I didn’t want to stay on it long term. I'd made other changes that I've shared to improve my sleep quality as well.

I wasn't sure what else I could do.

I was always cautioned to stay away from hormone treatments due to my mother’s history of breast cancer. 

My current medical providers weren’t sure about what to recommend hormone wise either.

Very overwhelming and difficult to find any good advice.

I kept searching and finally heard about a Menopause Specialist.

I did a consult with her in March.

As we dug into my symptoms, I realized I’d started having issues with my bladder.

Not UTI’s but increased frequency during the day and night.

More bathroom trips at night.

And if I had a full bladder and coughed or sneezed, I’d have to prep with a pelvic floor contraction or I might leak.

It just kind of snuck up on me over the years.

Looking back... my bladder was slowly becoming overactive.

Estrogen plays a protective role in our Bladder Health as well as preventing vaginal atrophy and dryness.  It keeps the urinary tract and vaginal tissue healthy and flexible.

Turns out I was a candidate for low dose vaginal estrogen therapy (i.e. Estradiol 0.01%) as it’s NOT systemically absorbed by the body.  It's a local treatment.

The first week I used it, I slept better than I had in YEARS. 

The biggest change- my bladder wasn’t waking me up as frequently. It could hold more so I was getting deeper sleep.

Bonus Ender's (and our dog-Teddie's) snoring wasn't waking me up!

And I was waking up more rested.

I stopped Melatonin after a few treatments of vaginal estradiol without any issues.

After a few weeks, I was rarely waking up to go to the bathroom at night. That literally hasn't happened since my late 30's.

I also started noticing I didn’t leak if I forgot to prep with a Kegel contraction before a sneeze or cough.

After a few months, I’m telling everyone about it.

Vaginal Estradiol is safe to use in menopause and post menopause indefinitely for bladder issues (stress or urge incontinence, frequent UTI’s) and/or vaginal issues (pain, dryness, atrophy).

The urologists I follow on X can't stop shouting how they give it to all their patient's with frequent UTI's. No more antibiotics.

You can even use it as a preventative for atrophy that will occur when there is low Estrogen levels.

Atrophy can lead to prolapse of urethra, bladder, vagina, or rectum. Trust me something you do not want to happen if at all possible.

It can be used in perimenopause if you’re symptomatic as well.

It's typically 1 gram of the cream 2-3 times per week but also comes in tablets. And no it's not messy.

So simple and so much to gain.

You’ll know after a few applications if your body finds it beneficial. 

I recommend you talk to your gynecologist or urologist about it (today).

NOTE: You may hear that there is a Black Box warning that it should not be used in those with breast cancer or risk of it. Don't freak out- do your research. The data shows local vaginal therapy does NOT increase risk of breast cancer. There are no studies showing it spreads to other areas of the body or blood. It does not increase risk of blood clots, heart disease, or dementia. There are oncologist that recommend it for their breast cancer patients even those in active treatment. Talk to a specialist or keep searching for a physician that can address your symptoms and personal medical history (especially if they're stuck on this issue).

I look forward to a day when all post menopausal women will be prescribed vaginal therapy just like we brush our teeth daily.

Consider adding it to your Healthy Bladder Toolbox.

It's never too late. I've heard stories about women in their 80's and 90's finally getting relief when their daughters got them on it.

I’m so grateful that my quest for deep sleep led me to it. 

Despite my focus on promoting having a healthy pelvic floor, I truly didn't connect the dots on the changes in my own bladder function until I experienced these improvements.

 Resources: 
 

• Virtual Menopause Specialists: Gennev 
• Follow these Urologists on X (check out their pinned tweets about this topic): Dr. Ashley Winter (@AshleyGWinter) and Dr. Rachel S. Rubin (@drrachelrubin)

If you suffer from leaking or frequent urination, there are a few more potential causes to consider besides Bladder irritants and low Estrogen. I cover them in Part 3 the Healthy Bladder Series.

Remember leaking is common with aging but not normal. 

There is hope. You just have to uncover the cause/s and figure out a plan to address it.

To A Healthy Bladder!
Mollie

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