Dr Sarita Naik (Narang) is a specialist Urogynaecologist who deals with women’s urinary and menopausal issues. She is a gold medalist doctor from Delhi, trained in Urogynaecology from Singapore and is now settled in Mumbai . With 18 years of extensive experience in her field, she believes that medicines and surgery can treat a patient but compassion truly heals.
Dr Sarita spoke about issues sensitive to women who have crossed the age of menopause, are perimenopausal/ post menopausal, over the age of 50 years; these are also issues that women do not talk freely about. They have the hesitation, reluctance to speak about this issue and concerns.
Urinary symptoms cannot just be physically distressing, they can also affect the woman’s mental well being.
Some frequent complaints faced by women over the age of 50 years is:
- Leaking urine while laughing/ coughing/ bending
- Frequently passing urine
- Increased micturition
- Increased urgency of passing urine
- Leaking of urine before you reach the bathroom
- Lump/ swelling felt in your private parts
- Frequent and repeated UTIs (Urinary Tract Infections)
How to recognise if you have a urinary tract infection:
- Increased frequency
- Sensation of urgency
- Pain while passing urine
- Burning sensation while passing urine
- Inability to hold your urine (incontinence)
- Blood in urine
- Smelly urine
- Foggy urine
- Discomfort in your lower abdomen
- Fever (+/-)
Women have a higher chance of contracting UTI. Women can contract a UTI 3-5 times more commonly than men. This is because the female urinary tract is shorter. It is also very close to the vagina where the vaginal secretions fall, so does the menstrual flow which can contaminate the urinary tract opening. It is also in close proximity to the anus- this is also why UTIs are very common with patients also suffering from constipation, fecal incontinence.
Many senior women wear a pad/ diaper/ panty liner to prevent any leakage, but many times, it is these pads and liners which can cause contamination, leading to urinary tract infections.
Repeated UTI is when you contract UTI more than 3 times in the last 6 months. This can be bothersome for the patient herself. And it needs to be investigated and treated for the cause at the earliest.
Necessary precautions you can take as a woman, to avoid contracting a UTI:
- If you feel discomfort down below while passing urine, start drinking more water. Start with 6-8 glasses a day, increase it to 8-10 glasses.
- If you are someone who works in a place with little/ no access to clean washrooms or encounter a situation where the public toilets were not clean and you had to hold your pee- keep a sachet of Citra-Soda, Syp Alkasol- these are simple urine alkalisers.
- Taking antibiotics on your own, without the prescription of a doctor is not recommended. This can lead to antibiotic resistance.
- When you visit a doctor, they will advise you a sonography to check your kidneys, the retention capacity of your bladder, etc. to narrow down the cause for your infection
Prevention of UTI:
- If you are diabetic/ are in an immunocompromised state/ have poor nutrition- maintain your water intake at an average of 6-8 glasses of water.
- Always clean from front to back. Cleaning from back to front should not be allowed/done. Do not use a rubbing movement either.
- For those who are equally active- pass urine before and after engaging in sex.
If you have been facing repeated urinary infections, do not sit back, seek the help of a doctor. Repeated urinary infections can also damage your kidneys.
The doctor may also have you checked for diabetes and sometimes even advise an endoscopy/ cystoscopy.
Once a woman attains menopause, her vagina becomes dry, shrunken and dehydrated- because of which the immunity to fight bacteria is lost leading to higher risk of contracting UTI.
In such cases, hormonal (oestrogen) creams are given, after thorough examination by the gynaecologist.
Another symptom that women in the senior age group suffer from is urinary incontinence- leaking of urine when trying to hold/ involuntary passage of urine.
Leakage of urine can happen at any time. This is not just a social concern, it is also a hygienic concern. It also starts affecting the quality of life. Due to the taboo associated to it, this is highly underreported in India.
Overactive bladder is another condition. This entails the female having a strong urge with increased frequency and a significant urine leak.
It is defined as someone who goes to the washroom more than 8 times/ day or more than 2 times in the night. Such individuals should get themselves evaluated for an overactive bladder.
Stress urinary incontinence is when there is leakage of urine on laughing/ coughing/ sneezing/ exertion.
The impact of urinary incontinence and leaking of urine is very high on the mental and social life of a woman. There will be limitation and cessation of physical activity. Reduced physical activity can worsen the diabetic/ blood pressure control of a the woman, leading to greater health concerns.
Anyone who is rushing to the washroom at night, is at a high risk for falls.
Rashes and urinary and vaginal infections are common due to diapers/ liners.
