Minding the Zs and Ps

Laura and I are presenting to Nutritionists in Industry at their Women’s Health meeting bringing up the lesser spoken about issues that affect women through and post menopause. Sleep and bladder issues are often mentioned by women but often in passing. There is often a sense that they are inevitable and just have to be put up with. Yet these can have huge impacts on health, well-being and quality of life.

Tomorrow, our aim is to raise awareness of these issues and placing them in the context of menopause. There are so many interconnections with menopausal symptoms and related health issues – either being aggravated by symptoms or amplifying the symptoms or their effects on health.

The drop in oestrogen impacts so many systems in the body. One important relationship is that between oestrogen and serotonin. The enhancing power of oestrogen on serotonin means that wherever serotonin is important there may be a noticeable effect during menopause as the enhancing effect of oestrogen drops.

Serotonin is dubbed the happiness hormone but that title does the influence of this neurotransmitter a disservice. It is not only important for mood. It is essential for melatonin production and so it impacts sleep, something that menopausal women often complain becomes harder to get.

The weakening in the sleep wake cycle can impact other aspects of the body including the night time down regulation of urine production. We also know that SSRI’s used for depression can also be helpful for bladder dysfunction – there is a role for serotonin in the nerves for bladder control.

It is interesting to note that 40% of women over 40 experience nocturia – having to get up more than twice a night to empty the bladder. Oestrogen also affects the pelvic area in ways that can impact bladder function directly. The drop in oestrogen can lead to an increase in the frequency that women need to empty their bladder and increase the incidence of UTIs and urgency.

Bladder function and anything related to incontinence is a taboo subject. As a result, women are managing symptoms that can be debilitating and bad for their wider health. Not just from lack of sleep but also reduction in exercise. Bladder issues can also result in poorer hydration which also affects health but exacerbates the very problem that caused the reduction in hydration.

Part of the presentation will be highlighting how we as nutritionists through conversations about hydration may be in a position to open conversations, realise that these things are common and often treatable if they seek help from their doctor.

If you are becoming an A-Z of where toilets are everywhere you go or are visiting the toilet more often than you would like, keep a bladder diary and go speak to your doctor. It is most likely that there is something that can be done.

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