Once you have run out of estrogen, you may find yourself faced with frequent urinary tract infections, because the tissue of the urethra and bladder may become thinner and lose its elasticity and thus become more open to infection or irritation. This is a concern you should take to your physician immediately to make sure you do not experience repeated infections that could endanger your bladder or kidneys. Other urinary symptoms that are common causes of discomfort after menopause include a change in the frequency of urination, an urge to urinate that is so pronounced that you can barely hold it in until you get to the toilet, and what is to many women the worst of all: the inability to hold in urine under stress. Physicians refer to this condition as stress incontinence.
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A little urine may leak when you laugh, sneeze, cough, or run to return that tennis ball. A full description of how to do Kegel exercises, which may help, is in Chapter 10.
What can cause depression in menopause, and WHAT CAN BE DONE ABOUT IT?
Minor depression occurring around the time of menopause affects a significant number of women. It may be the result of night sweats (hot flashes that occur at night) which disturb healthy sleep patterns and which are frequently followed by chills and a need to cover and uncover oneself (or even to change nightclothes and bedclothes in extreme cases). The fatigue caused by interrupted sleep may itself cause us to feel depressed. It is important, however, that these menopause symptom-related feelings of depression be differentiated from emotional illness. Hormone replacement therapy may enable us to sleep better and feel better and, thus, will lift the minor depression caused by hot flashes, night sweats, insomnia, and other symptoms. However, it probably will have no effect on emotional illnesses. It is easy to confuse the depression, anxiety, mood swings, and irritability that may occur around the time of menopause with the same feelings caused by other environmental and psychological factors.
Earlier in this blog, I related a long list of life changes that often occur at the time of menopause: the illness or death of one or more of your parents; children leaving home and leaving you with an empty nest; the stress of your job; other stresses such as a magnified lack of certainty about your life/work choices, or your mate's midlife crisis or work crisis; or divorce, which is becoming more common later in life. You can see how easily the environmental causes of depression can become confused with the symptom-related causes. So, again, ERT or HRT may be worth a try and if your depression is caused by the symptoms related to a lack of estrogen, it should clear up fairly quickly once you begin replacement therapy. In either case, talk to your doctor! Some doctors say that estrogen has a mental tonic‚ effect; others disagree.