Is your UTERUS causing your urge to pee?

Urge incontinence is a form of urinary incontinence characterised by a sudden and intense urge to pee, often followed by leaks. Also called 'overactive bladder', it can be incredibly disruptive and distressing, impacting our daily lives and causing embarrassment.

But how are adenomyosis and urge incontinence connected? Let's take a look:

What is Adenomyosis?

Adenomyosis (ah-den-oh-my-osis) is a condition typically affects women in their 30s and 40s, although it can occur at any age. The exact cause of adenomyosis remains unclear, but factors such as hormonal imbalances, inflammation, and genetic predisposition may play a role.

When the endometrial tissue embeds itself into the muscular walls of the uterus, it can lead to an enlarged and tender uterus, along with a host of symptoms including prolonged and heavy menstrual bleeding, pelvic pain, and pressure in the lower abdomen.

Adenomyosis shares some commonalities with endometriosis, however the tissue only grows within the uterus walls. In endometriosis, lesions and nodules grow on other organs - such as the bladder -and within the pelvic cavity. Many women who are diagnosed with endometriosis also have adenomyosis and vice versa.

Okay - but how does it affect the bladder then?

You might be wondering how a condition affecting the uterus could possibly influence the way your bladder works - and the answer lies in how our organs sit in close proximity in our pelvic

The enlarged and inflamed uterus characteristic of adenomyosis can exert pressure on surrounding structures, including the bladder. This pressure can irritate the bladder lining, leading to heightened sensitivity and an increased frequency of urination. Additionally, the hormonal fluctuations associated with adenomyosis can also exacerbate bladder symptoms and cause leaks to occur.

So how do hormones cause leaks?

Hormones, particularly oestrogen and progesterone, play a significant role in both adenomyosis and bladder function. During the menstrual cycle, these hormones fluctuate, influencing the growth and shedding of the uterine lining.

In adenomyosis, these hormonal fluctuations can contribute to the growth of endometrial tissue within the uterine walls during the menstrual cycle, exacerbating symptoms such as heavy bleeding and pelvic pain. Oestrogen dominance, a common hormonal imbalance seen in adenomyosis, can impact bladder function, leading to increased urinary urgency and frequency.

Literally getting on your nerves?

Our nervous system also plays a vital role in regulating bladder function. The pelvic nerves, which innervate both the uterus and bladder, can become sensitised and hyperactive in response to inflammation and the hormonal changes associated with adenomyosis.

This heightened nerve sensitivity can lead to a phenomenon known as "cross-talk" between the bladder and uterus, where irritation in one organ triggers symptoms in the other. This means that women with adenomyosis may experience urinary urgency and incontinence as a result of this neural connection in the nervous system.

How can it be managed and treated?

Now that we understand the connection between adenomyosis and urge incontinence/ OAB, let's explore strategies for managing these symptoms.

Medical Management

Your GP/ specialist may recommend medications to alleviate symptoms of adenomyosis, such as nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and hormonal therapies to regulate menstrual cycles. These treatments may help alleviate bladder symptoms indirectly by addressing the underlying hormonal and inflammatory imbalances.

Pelvic Floor Exercises

Strengthening the pelvic floor muscles through exercises such as Kegels can help improve bladder control and reduce urinary leakage associated with urge incontinence. If you aren't sure where to start, check out our Pelvic Floor 101.

Lifestyle Changes

Making simple lifestyle changes such as limiting caffeine and alcohol intake, maintaining a healthy weight, and practicing bladder training techniques can significantly improve bladder symptoms and enhance overall quality of life.

Surgical Options

In severe cases of adenomyosis where conservative measures fail to provide relief, surgical interventions such as hysterectomy may be considered. As there is no known cure for adenomyosis, hysterectomy is the only option that can provide full relief from the condition - but there are risks involved that you should consider with your specialist.

If you're experiencing symptoms of adenomyosis or urinary incontinence, don't hesitate to reach out to your GP for support and guidance.