Treatment of urinary incontinence in women after menopause: A review of recommendations

This study reviewed different therapy options to treat urinary incontinence (UI) in women after menopause. 

UI consists of the involuntary leakage of urine. This can happen due to stress put on the bladder (when coughing or sneezing), urgency, or overflow of urine. Menopause is the period that marks the end of the reproductive life of a woman (is diagnosed after 12 months since the periods have ended). The occurrence of UI increases after menopause and affects 38 to 55% of these women. Even though UI has a significant effect on the quality of life, few women seek care.  

During this period women can experience different types of UI. UI specialists should detect the specific type of UI and apply the correct treatment. Previous guidelines were not up to date in terms of new therapies for UI in these women. The European Menopause and Andropause Association (EMAS) suggested that further guidelines are necessary for the treatment of these patients. 

This article reviewed the EMAS recommendations for the treatment of UI in menopausal women.

Healthcare professionals should consider UI a priority. They should be able to detect and manage other common urinary problems associated with UI such as infections.

The first-line treatment consists of lifestyle and behavioral changes, pelvic muscle-training, and bladder training. Medication such as estrogen helps to treat urgency UI. Other medications such as anticholinergic medications and mirabegron (Myrbetriq) are also useful in urgency UI.

Third-line treatments such as sacral neuromodulation help to treat selected patients with urgency UI. This treatment uses electric impulses sent to the bladder muscle in order to stop urine leakage. Onabotulinum toxin A (Botox) injections have also been proved effective in stopping urine leakage.

In women with stress UI, surgery should be considered. Urinary slings are safe and have confirmed effectiveness in treating UI.

This study concluded that the personalized treatment of UI on women after menopause should be a priority. Successful treatment depends on the correct diagnosis and treatment.