In my menopause rabbit hole (if you aren’t following my blogs, just know that I have been recently a tad obsessed), I was reading the information about peeing. (They call it bladder health). I see this often in premenopausal women who blew out their bellies when they were pregnant.
I see urinary issues all the time in my tummy tuck patients before I do surgery. When you do an abdominoplasty, even though the muscle I tighten when I fix your diastasis is your rectus abdominus muscle (the six pack), we see all sorts of improvement in the pelvic floor. Yes, tummy tucks are not just an aesthetic procedure. They help reinforce and repair the core, and as part of that the pelvic floor. Common comments I hear after tummy tucks:
- “I don’t have to pee in the middle of the night”
- “I don’t pee when I run/cough/laugh.”
- “My bowel habits improved. I don’t need pills/laxatives/etc.”
- “I have better sex.”
If you have the pee issues, you can also have surgery done by an ObGyn to do a sling, where you support the urethra. I don’t do those.
But for those who don’t need/want surgery, what can you do to help? Kegel exercises do work. You hold the squeeze for 10 seconds. Try not to drink tons of liquids, empty your bladder more frequently, lower your weight. Turns out here is one area where systemic estrogen may not help, but vaginal estrogen does.
If you have recurrent UTIs, you should see your MD. They should do a culture (is it the same thing each time? is it resistant?). When you hit menopause, your microbiome of your vagina changes, things become dry and more easily irritated, and you have less blood flow. Things that are talked about but not proven: cranberry, probiotics, and peeing after sex. There are some lasers touted to help- that is out of my purview as a plastic surgeon, but you can read the studies HERE.
You can also see fat grafting to the vaginal area. It is a burgeoning area in plastic surgery, which started with beautification of the vaginal area, but also the stem cells which come with fat grafting can improve issues of dryness and pain. blogs. HERE