Can More Frequent Urination Be a Symptom of Perimenopause ?
You aren’t imagining it: There may very well be a link between perimenopause and more frequent urinating than usual, including those overnight trips to the bathroom.
How many voids per 24 hours define urinary frequency?
“Although there is no absolute number of daytime voids that is ‘abnormal,’ urinary frequency is typically defined as more than eight voids/24 hours,” says R. Mark Ellerkmann, MD, Director, The Urogynecology Center at Mercy Medical Center, Baltimore.
“However, many things can influence the degree of urinary frequency — how much one drinks, what one drinks, whether someone is on a diuretic, etc.”
So right off the bat, you may want to ask yourself if perimenopause has been making you consume more fluids, though thirst is not a symptom of perimenopause.
Overactive Bladder
Dr. Ellerkmann says that usually, complaints of urinary frequency come with additional symptoms:
• Urinary urgency (“sudden, compelling desire to pass urine which is difficult to defer”)
• Nocturia – getting up in the middle of the night to relieve oneself more than once
• Urge related
“The constellation of these symptoms provide for a clinical diagnosis we refer to as overactive bladder or OAB (defined as urgency, often with frequency and nocturia, with or without urge related urinary incontinence),” explains Dr. Ellerkmann.
Severity does increase with age, but perimenopause typically occurs in a woman’s 40s. Urge related incontinence is more common in women.
“Urge incontinence increases with age, from 17 percent of women older than 45 years to 27 percent of women older than 75 years of age.”
The Perimenopause and Urinary Frequency Connection
“Perimenopause is defined at that period of time leading up to menopause,” says Dr. Ellerkmann.
“Many physiological changes occur during the perimenopausal time period as levels of circulating hormones — estrogen, progesterone and testosterone — fluctuate and levels slowly decrease.
“The effects of estrogen on the urogenital tract are well-known, as these tissues (the vaginal and peri-urethral tissues/bladder) are very rich in estrogen receptors.
“As circulating estrogen levels decrease and become less consistent, vaginal and peri-urethral tissues become less well-lubricated; they become thinner and less elastic and less well-vascularized [stocked with blood vessels].
“It may be that the loss of estrogen can adversely affect the bladder, but whether the hormonal changes of perimenopause are directly related to symptoms of urinary frequency is difficult to say.”
Solutions to Increased Urinary Frequency from Perimenopause
Dr. Ellerkmann says that some studies support the use of supplemental vaginal estrogen cream in both periomenopausal and menopausal women to partially alleviate symptoms of overactive bladder.
Dr. Ellerkmann also explains, “Excluding organic causes that might cause overactive bladder symptoms (bladder cancers, stones, bladder prolapse, infections, foreign suture or mesh from urological surgery) or medications (diuretics) or behavior (excessive consumption of liquids), the most common inciting causes of urinary frequency and urgency are consumption of known dietary irritants — the most common of which are caffeinated beverages, tea, artificial sweeteners, carbonated beverages, citrus juices, tomatoes, chocolate, sodas.”
Dr. Ellerkmann
is board certified in both OB/GYN and female pelvic medicine and reconstructive surgery. He specializes in the treatment of urinary incontinence in women of all ages.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Feel Like You Must Pee Really Bad after a Pap Smear ?
Did your Pap smear make your bladder feel full enough to burst, like you had to pee a whole gallon?
So after the doctor is finished with the Pap smear, having removed the speculum and completed the digital exam, you’re left lying immobile because it feels that your bladder is suddenly filled to the hilt with urine.
But you know there can’t be any urine in there because:
• You relieved yourself right before the exam.
• You didn’t even have a drop of water prior to the exam.
• The preceding day you went light on the water.
You induced dehydration to lessen any bladder discomfort from a Pap smear, but this time, the urge to pee was overwhelming. What could cause this?
“The only comment I would have on this question is that (depending on the examiner and the patient) a pelvic examination (speculum placement, bimanual examination) can possibly irritate the vaginal tissues and may cause a patient to have transient overactive bladder symptoms,” says R. Mark Ellerkmann, MD, Director, The Urogynecology Center at Mercy Medical Center, Baltimore.
The severe urge to pee after a Pap smear has nothing to do with the actual buildup of urine in the bladder.
#1 Urine comes from the kidneys.
#2 A Pap smear cannot magically make urine fill up the bladder.
#3 It’s only an illusion.
The vagina is also very close to the urethra, so any handling of the vagina could irritate the urethra, simulating an urge to void.
And all of this is what you must remind yourself for your next Pap smear, especially when it’s completed and you’re lying there very still, feeling as though at any moment you’re going to leak.
Give this sensation five or so minutes to pass. Just lie there and breathe deeply, eyes closed. Tell your doctor why you want to just lie there, then do it.
Dr. Ellerkmann adds, “It is highly unlikely that a pelvic examination increases the risk of a urinary tract infection — often responsible for transient OAB symptoms — or any trauma to the pelvic floor.
“It is just that pressing and palpating (feeling) the bladder and uterus can cause a sensation of ‘needing’ to go.”
Dr. Ellerkmann is board certified in both OB/GYN and female pelvic medicine and reconstructive surgery. He specializes in the treatment of urinary incontinence in women of all ages.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Here’s Why It’s Hard for Type 1 Diabetics to Get Pregnant
The high blood sugar of type 1 diabetes doesn’t interfere with GETTING pregnant, but instead causes another problem once a woman IS pregnant. (more…)
Why Does Diabetes Cause Shiny Skin on the Lower Legs?
“This condition is known as diabetic dermopathy, characterized by thinning, shiny, friable skin due to microvascular changes in the small blood vessels in the skin,” says Jenepher Piper, a family practice nurse practitioner for Maryland Family Care for 25+ years and a former nurse with Home Care Nurse for Johns Hopkins Home Care.
“This is similar to the changes that occur to the retina of the eye (diabetic retinopathy).”
It is unknown what the underlying mechanism is of diabetes dermopathy, according to a report by the British Journal of Diabetes.
Despite the appearance, with can be mottled and include shiny sections, this condition does not cause symptoms.
The skin lesions do not require treatment.
If you notice what seems to be this condition on your legs, even if it doesn’t appear to be shiny, and your last checkup did not show diabetes or you were not tested for it, you should get retested!
Patients suffering from conditions such as coronary artery disease, obesity and diabetes turn to Nurse Practitioner Piper to help them best manage their overall health.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Source: bjd-abcd.com/index.php/bjd/article/viewFile/24/63
When Those Scary Sock Indentations Don’t Mean Edema
Discovering you may have edema, thanks to worrisome indentations in your skin caused by socks, is pretty unnerving.
That’s because edema can be caused by problems with the heart or kidneys. (more…)
Just What IS “Cloudy” Urine? Its Appearance and Color
The term “cloudy urine” comes up often on medical sites, but there’s no description of just what this is.
It’s open to subjective interpretation. To some people it can mean a milky colored urine.
To others it may bring to mind a cloudy color, kind of grey-like.
And to other people it can mean a murky quality to their light orange urine – the orange being from dehydration.
“Cloudy” is an overly broad term.
“Cloudy urine refers to urine that is not clear but uniformly opaque, like a cloud,” says Jenepher Piper, a family practice nurse practitioner for Maryland Family Care for 25+ years and a former nurse with Home Care Nurse for Johns Hopkins Home Care.
You may still be able to see through this type of excrement if it’s in a clear plastic cup.
It may also be cloudy enough or solid-looking enough that you would not be able to see your finger on the other side of the plastic cup.
“Cloudy urine doesn’t imply any change from typical urine color, light to dark yellow,” says Piper.
In other words, the murkiness can be present in any color on the urine spectrum, from clear/pale yellow to medium yellow to dark yellow to yellow-orange to light orange to orange (these colors are determined by hydration levels).
Urologic Oncologist’s Description of Cloudy Urine
“‘Cloudy’ urine can describe a wide variety of urine,” says Michael Herman, MD, director of urologic oncology at South Nassau Communities Hospital in Oceanside, NY.
“It can range from urine that is just slightly translucent to flakes of sediment in the urine to urine that looks almost milky it is so cloudy.”
There are many causes of the so-called cloudy urine, and some of the non-cancerous causes can still be serious.
Patients suffering from conditions such as coronary artery disease, obesity and diabetes turn to Nurse Practitioner Piper to help them best manage their overall health.
Dr. Herman’s interests include reducing the over-diagnosis and over-treatment of prostate cancer by utilizing the latest biomarkers and imaging techniques. He is at the forefront of treatment and research of urologic cancers.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Andrew Safonov
Very Watery Eyes in the Morning: Causes & Solutions
Ever awaken with watery eyes? There are three basic causes to this annoying problem.
The first cause of both eyes being watery in the morning will surprise you. (more…)
Top 5 Causes of a 24/7 Headache Include Brain Tumor
If you’re wondering if a 24/7 headache can be caused by a brain tumor, the answer is yes, but there are four other leading causes of a headache that just won’t go away.
If you’ve been suffering from a nonstop or nearly nonstop headache, 24 hours a day, seven days a week, it’s only natural to place a brain tumor at the top of the list of possible causes.
Many people’s first thought, about their 24/7 headache, is that it might be a brain tumor.
They google information about this but do not come up with anything reassuring.
Jenepher Piper has been a family practice nurse practitioner for Maryland Family Care for 25+ years and a former nurse with Home Care Nurse for Johns Hopkins Home Care. I asked her what were the top five causes of a 24/7 headache.
Causes of headaches span a wide range of medical domains, from neurosurgery to the ear, nose and throat specialty to neuropharmacology to cardiology and more.
Piper has worked with thousands of patients with all sorts of medical issues—including headaches from a variety of causes.
So according to Piper, here are the top five causes, in descending order, of a 24/7 headache:
Chronic Sinusitis
“Usually a result of uncontrolled allergic rhinitis causing chronic tissue swelling surrounding the nose, ears and throat, leading to blockage of sinus fluids and an increased pressure sensation or headache,” says Piper.
Hypertension (High Blood Pressure)
This cause will be the farthest thing from many people’s minds, as hypertension typically does not cause symptoms (it’s dubbed “the silent killer” by doctors).
People are taught to associate high blood pressure with an increased risk of stroke, not constant headache.
Piper explains, “Elevated blood pressure causes an increase of spinal fluid in the brain leading to increased intracranial pressure.”
Medication Side Effect
“Any substances leading to fluid retention (NSAIDS, prednisone, hormones) and intracranial pressure,” says Piper.
Medication Misuse/Overuse
“‘Chronic daily headache’ is a common term associated with a type of headache or migraine that has been ineffectively or improperly treated, eventually leading to a ‘medication rebound’ headache, dependent on the presence of chronic substance overuse (caffeine, anti-inflammatories, opiates or even medications developed specifically to treat headache like Imitrex or Maxalt, to name a couple),” explains Piper.
Brain Tumor (Rare)
A brain tumor “occupies space, pressing on vital structures and increasing pressure in the head by backing flow fluid and blood.”
The rareness of a brain tumor causing a constant headache is relative to the likeliest cause of this troubling symptom. That’s why it ranks at the bottom of the five.
So many more people suffer from the first four conditions that, from that perspective, the brain tumor IS rare.
However, among brain tumor patients, headache occurs in about 50 percent, says the American Brain Tumor Association.
Early on in a new-onset 24/7 headache that’s caused by a brain tumor, there MAY be no other symptoms.
But soon enough, there will be other symptoms, and they can run the gamut, but the more common ones are seizures, visual disturbances, cognitive changes, vomiting, nausea and weakness. It also won’t usually respond to common pain remedies.
A brain tumor headache also is usually worse in the morning. But honorable mention for a possible cause of an ongoing headache is sleep apnea.
The sleep apnea headache, like the brain tumor one, is typically worse upon awakening in the morning.
Patients suffering from conditions such as coronary artery disease, obesity and diabetes turn to Nurse Practitioner Piper to help them best manage their overall health.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Sources:
abta.org/brain-tumor-information/symptoms/headaches.html?referrer=https://www.google.com/
mayoclinic.org/diseases-conditions/sleep-apnea/basics/symptoms/con-20020286
Causes of Both Legs Aching After Standing a Few Minutes
If both of your legs begin aching after you’ve been standing for only a few minutes, and this keeps happening, there are four likely causes, and one is serious. (more…)
Can You Gain Fat Drinking a Lot of Water?
Many people actually wonder if drinking large amounts of water on a recurring basis can cause you to gain fat.
Certainly, drinking a lot of water over a short period of time can make you feel bloated and heavy in the middle.
Maybe this is what causes some people to wonder if fat cells can be made bigger by water intake.
Water contains zero calories. It’s the stuff that doctors urge people to drink a lot of for weight loss, yet people think it could ADD fat too.
Where did the idea ever come from that drinking “too much” water can cause one to gain fat? Who knows, but here is some data…
If you drink way too much water, you’ll get what’s called water intoxication. It can be life threatening, and in fact, people have died from this.
If you drink 16 ounces of water all at once, your weight will be 16 ounces heavier than what it was prior.
That’s water weight, even if you feel bloated and even if you can see your belly sticking out a little more (from the fluid).
“NO, you cannot gain fat by drinking water,” says Susan L. Besser, MD, with Mercy Medical Center, Baltimore, and Diplomate American Board of Obesity Medicine and board certified by the American Board of Family Medicine.
Dr. Besser continues, “You may gain weight, temporarily (water weight), but as soon as you get rid of the extra water, the weight goes away. Water has NO CALORIES; it can’t be converted to fat (or anything else).”
The more water you drink, the more you must urinate. Your body is very efficient at managing water intake – up to a point.
Death, not Fat, by Water
There are rare cases in which a person drinks enormous amounts of water over a very short period of time and dies because of this.
No matter how much water you drink, it will have zero effect on your fat cells, in that it will not increase the volume of fat.
Drinking a ton of water will not indirectly cause fat gain, either.
But what makes someone drink enough H20 to die?
One such case was a high school football player who felt that drinking two gallons of water would alleviate his cramps.
Another was a woman who drank two gallons as part of a radio station contest.
A third person was a college man who drank too much water during fraternity initiation.
Excess water as in these cases causes cells to swell with fluid, which can lead to swelling in the brain and then brain death.
No amount of water causes fat gain.
Have you ever heard of a doctor or nutritionist telling a skinny person who wants to gain weight to drink more water?
Dr. Besser provides comprehensive family care, treating common and acute primary conditions like diabetes and hypertension. Her ongoing approach allows her the opportunity to provide accurate and critical diagnoses of more complex conditions and disorders.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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