Menopause, GSM & Estrogen Atrophy

If your doctor suspects that estrogen atrophy and menopause has made your bladder more sensitive, look for products that are calming, soothing and support the health of the bladder wall will be a priority. Products that contain chondroitin are usually preferred.(1) 

Key Patient Education Tips

The bladder wall has three key layers: an outer mucosal GAG) layer, several layers of urothelial cells and, at the deepest level, blood vessels, nerves, mast cells and the smooth muscle of the bladder wall. When you are young and have lots of estrogen, your GAG layer is very thick and acts as a barrier between urine and the more tender tissues of your bladder wall. As you age and your estrogen levels drop, the GAG layer thins. This also happens to your vulva, vagina and urethra. This drier skin allows urine to penetrate deeply  where it will trigger irritation and/or pain. This is not a disease. This is the result of aging. 

One common sign of estrogen atrophy is a burning sensation on the vulva as urine is passing over it during urination. This is because the vulvar skin is dryer and more sensitive. The urethra may become more sensitive and irritated. It can feel like a drop of urine is stuck in your urethra. 

Generally, doctors first discuss the pros and cons of topical hormone therapy (i.e. estrogen) that may help your tissue grow and produce more moisture. This can be remarkably helpful for many. The American Urology Association suggests that patients try OTC nutraceuticals in Step One of their Guidelines for IC/BPS. Here are some options that you can consider.

Nutraceutical Options


AloePathBladder BuilderBladder Rest
ALOEPATH® - For a soothing and pain reducing effect

BLADDER REST® - For a simple chondroitin based protective effect

BLADDER BUILDER® - Our most comprehensive formula provides a coating, soothing, pain reduction and biome support

PRVNT® - For the prevention of urinary tract infections

PEAORA®
 - For chronic pain relief


CystoProtek® - For a coating effect with chondroitin and hyaluronate.

*It's not unusual for some to have sensitivities to various ingredients. Please review the label carefully for any known allergens. We suggest starting small. Try one capsule and see how your body handles it. If you feel good, try one a day for a week and again assess. If you are doing well, you can gradually increase to the manufacturers recommended dosages. Of course, if you struggle with any side effects, stop the supplement and talk with your physician.

Topical Therapeutics
 

V-Magic - For dryness on the vulva

Luvena Vaginal Moisturizer & Lubricant - For vaginal dryness

Luvena Personal Moisturizer - For intimacy and lubrication

For UTI Prevention

Another issue which can emerge is recurring urinary tract infection. Why? Because the GAG layer also provides a barrier for bacterial infection. Unfortunately, as the GAG layer thins, bacteria have a greater chance to reaching and infecting bladder cells. PRVNT® is stronger and more affordable option than Ellura®.



Personal Hygiene



Basis Soap For Sensitive Skin -
For skin made more sensitive due to dryness and estrogen atrophy

Perineal Wash Bottle - To rinse all urine residue from your skin after urination. 

Reference 

1. Rozenberg BB, et al. IMPROVING THE BARRIER FUNCTION OF DAMAGED CULTURED UROTHELIUM USING CHONDROITIN SULFATE. Neurourol Urodyn. 2019 Nov 27.

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