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Urinary problems in women

This page is about sex hormone symptoms and urinary problems in women. There is information about

 

Hormones and urinary problems

Some cancer treatments lower sex hormone levels in the body. In women, these hormones are oestrogen and progesterone. Low levels of sex hormones can sometimes cause urinary problems in women, including infections and incontinence.

Oestrogen helps to keep the wall of the urethra elastic and the pelvic floor muscles healthy. The urethra is the tube that takes urine from the bladder to the outside of the body. The pelvic floor muscles surround the lower part of the bladder and urethra. When the amount of oestrogen in the body falls it can weaken the muscles and make the urethra less elastic. This can lead to incontinence or infection.

Not everyone who has low levels of sex hormones due to cancer treatment develops urinary problems. In one study 1 in 10 (10%) women had problems but the true figure may be higher. Researchers suggest that some women choose not to tell their doctors or nurses because they are embarrassed. Or women may think it is just something they have to put up with. Urinary problems can be a very difficult problem to cope with and can have an impact on how you feel about yourself and your quality of life.

Some women are able to have hormone replacement therapy (HRT) to control any symptoms. But you can’t take HRT if you are having treatment for breast cancer that aims to stop the body producing sex hormones or block their action. But there are other things that may help.

 

Urinary infection

Symptoms of a urine infection are

  • A frequent and urgent need to pass urine
  • Pain or burning when you pass urine (cystitis)
  • Pain in the abdomen, back or sides
  • Blood in the urine
  • A high temperature, chills and feeling sick

The number of women who have had breast cancer and develop urinary tract infections or cystitis is between 5 and 8 out of 100 (5 to 8%). If you have diabetes or a prolapsed bladder your risk of developing these problems is slightly higher.

You can reduce your risk of urinary tract infection by drinking plenty of fluids (about 2 litres a day). You can also reduce your risk of urine infection by emptying your bladder before and after sex. Some people think that drinking cranberry juice can help reduce the symptoms of cystitis but research has not confirmed this.

Vaginal dryness can cause irritation in the area especially during and after sex. This may increase the risk of infection and pain when passing urine. There are various ways of reducing vaginal dryness including creams and moisturisers. There is information about what you can do if you have vaginal dryness on our page about sex and sexuality and hormone symptoms.

Do talk to your doctor or nurse if you think you have an infection. You’ll need to have antibiotics.

 

Urine leakage (incontinence)

Incontinence is not a common symptom of low sex hormone levels. It is much more likely that there is another cause. Or incontinence may be due to a combination of factors, including low oestrogen levels. Do tell your doctor if you have urine leakage. It may be easily treated. Treatments include pelvic floor exercises, tablets and occasionally surgery. Urine infections and swelling caused by friction during sex can also cause incontinence.

A Cochrane review in 2012 found that using a vaginal oestrogen helped to reduce incontinence. Vaginal oestrogen comes in two forms. It is available as a cream or a tablet called a pessary that you put into the vagina and gradually dissolves. The review also found that women needed to pass urine less often and less urgently when they used a pessary.

If you have had a hormone dependent cancer such as breast cancer we don’t yet know how safe it is to use vaginal oestrogens. Your body absorbs some oestrogen from them but the amount is very small. There is research suggesting that using vaginal creams or pessaries doesn’t increase oestrogen levels in the blood. But we need more research to find out how safe these products are to use after breast cancer.

If you have any urine leakage there are a number of different types of panty liners or pads you can use. It is best to try and avoid those with a scent because they may irritate your skin and make symptoms worse.

 

Coping with urinary problems

Urinary problems can be difficult to cope with. Many people feel embarrassed and this can have an effect on your quality of life. Many people find it difficult to talk about incontinence or bladder infections. It is important to tell your doctor or nurse if you are having problems. They will have helped many people with these problems before and can recommend the best treatments to help you.

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Updated: 5 August 2013