How Does Estrogen Cream Help The Bladder

What Else Can Cause Leakage

Menopause isnt always the reason why your bladder is acting up. Your muscles may have naturally weakened due to age. Or you might have had injuries as a result of giving birth to a child, or several children.

Condition like diabetes or multiple sclerosis can cause nerve damage, which in turn can also cause bladder problems.

Think about any medicines you take, too. Some antidepressants and pain meds can keep your bladder from emptying. Your doctor may be able to change your dose or prescription.

Continued

Reduced Cft073 Toxicity In The Presence Of Estradiol

We proceeded with evaluating the virulence of CFT073 in the presence of estradiol with an in vivo C. elegans infection model. This was done to evaluate the combined significance our findings had on the virulence of CFT073. We found that CFT073 in the presence of 5 and 300 pg/ml estradiol significantly increased the survival of C. elegans worms compared with unstimulated CFT073 . The dead worms were also visualized by the uptake of SYTOX Green . Estradiol per se did not induce any C. elegans toxicity .

Figure 8. CFT073 mediated C. elegans killing in the presence or absence of estradiol . Data are presented as mean ± SEM of n = 3 independent experiments. Statistical significance is denoted with asterisks: ***p< 0.001 vs. unstimulated CFT073. Immunofluorescence staining of dead worm with 1 M SYTOX Green . Scale bar: 1,000 m.

How Does Low Estrogen Lead To Overactive Bladder

The link between overactive bladder and estrogen is complex. Researchers are still studying the exact cause. However, there are several potential explanations that may shed light on estrogens effects on the bladder.

Low estrogen can cause many changes in the body, including weaker pelvic muscles and a thinner urethra lining. These changes may increase the risk for overactive bladder and poor bladder control after menopause.

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Application Of A Simple Cream Might Reduce Recurrence Of Pelvic Floor Dysfunction Symptoms

Many women experience overactive bladder or urinary incontinence after childbirth or around the onset of menopause. Additionally, many women are also diagnosed with pelvic organ prolapse, a condition under the umbrella term of pelvic floor dysfunction.

Pelvic organ prolapse occurs when weakness in the vaginal wall allows organs such as the bladder, uterus, or rectum to bulge into the vaginal canal, causing:

• Heaviness, bulging pressure, pain in the pelvic area
• Inability to control the bladder or bowels
• Reduced quality of life

Traditionally, pelvic organ prolapse has been treated with surgery. However, according to the National Center for Biotechnology, common surgical repairs are ineffective for nearly 20 percent of patients, resulting in the need for second surgeries to fully resolve their symptoms. Despite these alarming numbers, U.S. doctors continue to perform approximately 300,000 of these surgeries a year.

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Altered Cytokine Release Induced By Estradiol

We continued with evaluating if estradiol-stimulated CFT073, at MOI 10, could alter the release of IL-1 and IL-8 from bladder epithelial cells. We found that the cytokine release was significantly lowered by CFT073 stimulated with 300 pg/ml estradiol for both IL-1 and IL-8 compared with unstimulated CFT073 . No difference in IL-1 and IL-8 release was observed for CFT073 stimulated with 5 pg/ml estradiol . Furthermore, we did not find any differences in LDH release from bladder epithelial infected with estradiol-stimulated CFT073 compared with unstimulated CFT073 .

Figure 7. IL-1, IL-8 , and LDH release from bladder epithelial cells infected with CFT073 pretreated with or without estradiol at 6 h. Data are presented as mean ± SEM of n = 4 independent experiments. The asterisks distinguish statistical significance: *p< 0.05 and **p< 0.01 vs. unstimulated CFT073.

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Are There Any Complications Of Using A Pessary Long Term

Potential complications of long-term vaginal pessary use to treat pelvic organ prolapse include:

• Vaginal bleeding usually mild
• Treated by temporary removal of the pessary and use of antibiotics and vaginal oestrogen

The potential problems from having a vaginal pessary are minimal if the appropriate precautions are taken and ongoing review and check ups are performed.

Dr. Karen McKertich

Cytokine Release And Viability Assay

CFT073 was grown in MSM in the presence of absence of estradiol statically at 37°C for 24 h. Estradiol was washed away from the bacteria with PBS and the bladder epithelial cell line 5,637 was infected with the respective treatment at MOI of 10 for 6 h at 37°C and 5% CO2. Supernatants were collected after the infection and centrifuged for 5 min at 5,000×g and stored at 80°C. An enzyme-linked immunosorbent assay was performed to measure IL-1 and IL-8 release from the 5,637 cells. The cytokine was measured with the IL-1 and IL-8 kits according to the instructions of the kit. Cell viability after infection was assessed by Pierce LDH cytotoxicity assay according to the instructions of the kit.

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List Of Low Estrogen Bladder Symptoms

Some bladder symptoms that can occur due to low estrogen include:

• Incontinence: This means that a person loses control of their bladder. This can happen in any context. However, one of the most common forms is stress incontinence. This means that a person loses control of the bladder when there is pressure on the pelvic floor, such as when coughing, running, or laughing.
• Urinary pain: A person may have pain when urinating or shortly before or after. Some people notice that their bladder feels painful or full after urinating or that they are unable to fully empty their bladder.
• Overactive bladder : A person may urinate more frequently than usual or have difficulty holding their bladder when they need to use the bathroom.

A person with low estrogen may have genital symptoms, too,

not necessary for a diagnosis. However, doctors may occasionally use:

• vaginal pH testing
• vaginal culture to assess the health of the microbiome
• tissue biopsy, in cases where treatment does not improve the symptoms

If it is unlikely the symptoms are related to menopause, a doctor may perform other tests to rule out other conditions, such as UTIs. They may also assess someones hormone levels, bladder function, or nerve function.

A number of treatments may help with symptoms. They include:

• Hormone replacement therapy : For GSM or vaginal atrophy, a doctor

Some strategies for coping include:

Other Approaches To Treating Stress Incontinence

Using stool bulking agents or softeners will help avoid constipation and having to strain when opening your bowels. When emptying the bowels and bladder, it may also help to use a low stool to elevate the knees slightly higher than hips, relaxing the pelvic floor and the abdomen. Additionally, avoiding heavy lifting can help avoid raised intra-abdominal pressure leading to SUI.

Another non-surgical option is duloxetine, an antidepressant medication known as a serotonin and noradrenaline reuptake inhibitor . It may help some women but its use is not approved for this purpose in Australia or New Zealand.

Your doctor may recommend surgery if other treatments have not helped. You may be referred to a specialist urogynaecologist to discuss the benefits and risks of surgery for SUI. The types of surgery available for SUI include urethral bulking agents, midurethral slings, colposuspension, or an autologous fascial sling.

None of the types of surgery currently available have a 100% cure rate, however for 80-90% of women, their surgery will provide significant improvement at 12 months post-surgery.

For incontinence caused by neurological disorders, such as multiple sclerosis or spinal cord injury, management should be tailored to the individual womanâs needs.

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Menopause & Pelvic Organ Prolapse At A Glance

• Changes in a womans pelvic floor function often accompany menopause. Weakening of the pelvic support structures can lead to pelvic organ prolapse, in which one or more organs of the pelvic area drops out of place.
• While there are many causes of pelvic organ prolapse , the lack of estrogen during menopause thins the support structures and tissue that hold pelvic organs in place, causing them to fall.

Will Hormone Replacement Help With Bladder Control

Many women complain of urine leakage with activity or with an uncontrollable urge .

Some women feel there is a worsening of the urinary incontinence around the time of the menses. Still others notice a worsening of incontinence symptoms with menopause, when estrogen levels drop to very low levels.

That estrogen plays a role in these symptoms is pretty certain, but exactly how it affects urinary incontinence is not clearly understood. Estrogen has a enhancing effect on the vaginal and urethral mucosa, and the pelvic floor muscles, rejuvenating the tissues and making them more elastic.

The most noticeable effects of estrogen on urinary tract symptoms occur when it is applied locally. This provides high levels that produce dramatic tissue effects, while limiting blood levels and exposure to other body areas such as uterus or breast.

Studies show an significant improvement in post menopausal women urinary symptoms with vaginal estrogen, but ironically an increase in the symptoms when estrogen is given orally. The latter is consistent with women complaining of a worsening of the incontinence with the profession of their cycle, although it is not known exactly why this seems to occur.

The take home message is that vaginal estrogen can significantly improve urinary incontinence symptoms in post menopausal women.

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The Pattern Of Incontinence Is Often Mixed

Symptoms of overactive bladder include frequency and nocturia . Some women also feel they need to pass urine, having only just done so due to over activity of the bladder muscle.

Recurrent urinary tract infections

UTIs can affect women of all ages, but this problem increases with age as a result of estrogen deficiency.

Management of urinary problems

Local estrogen

Local estrogen replacement therapy has been shown to alleviate urgency, urge incontinence, frequency, nocturia, dysuria and also to reduce urine infections.

Genuine Stress Incontinence would not appear to be helped by estrogen alone, but it does seem to improve the action of other treatments currently used.

The newer treatments including Ospemifene, DHEA and laser therapy may all have a beneficial effect on bladder problems.

Pelvic floor exercises

These can strengthen the pelvic floor reducing the risk of uterovaginal prolapse. Many women have learnt these techniques from childbirth, but it is well worth revisiting them.

Pelvic-floor physiotherapists are specialists in this field and are able to fully assess and monitor a womans pelvic floor function and teach appropriate techniques to strengthen it and retrain the bladder. They often use devices to help women perform appropriate exercises, such as weighted vaginal cones, or vaginal trainers. Your practice nurse or GP should be able to refer you to a specialist pelvic floor physiotherapist.

Surgery

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Vaginal Estrogen And Pelvic Floor Physical Therapy In Women With Symptomatic Mild Prolapse

• Estrogen therapy in the previous year
• Current or prior breast or pelvic malignancy
• Contraindication to hormone use

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier : NCT01648751

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Local Estrogen In The Treatment Of Lower Urinary Tract Symptoms

A systematic review of 44 individual clinical studies from 2014 concluded that all available vaginal estrogen preparations reduce LUTS, including urinary urgency, frequency, lower urinary tract pain, urgency urinary incontinence and voiding dysfunction . Furthermore, some studies reported that local estrogen treatment improved the overall, subjective, objective and urodynamic variables in UI and overactive bladder also the mid-urethral closure pressure seemed greatest in patients treated with estrogens compared with pelvic floor exercises or electro-stimulation .

Caenorhabditis Elegans Killing Assay

The C. elegans wild-type Bristol strain N2 was maintained on nematode growth medium plates seeded with E. coli OP50 at 21°C. Prior to the experiments, C. elegans were synchronized and maintained on nematode growth medium plates for 48 h at 21°C to reach the L4 stage. CFT073 was grown in MSM in the presence or absence of estradiol statically at 37°C for 24 h. Estradiol was washed away from the bacteria and CFT073 was transferred to a 96-well plate. The L4 worms were washed with M9 buffer and 10 worms were then transferred to the respective well of bacteria that had been grown in the presence or absence of estradiol. After the addition of the worms to the wells, C. elegans and the bacteria were incubated together for 10 h at 21°C. The viability of the worms was evaluated every hour. A worm was considered dead when it failed to respond to touch. Dead worms were also visualized with 1 M SYTOX Green using a spectrophotometer .

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What Our Patients Say

As of March 2021, I have been a HerKare patient for 3 years. I have driven from the Austin to Ft. Worth and Southlake since March 2018. In fact, today I attempted to drive to Southlake to see the provider, Dania Khoncarly, because she is so amazing, but the roads were too dangerous with the current ice storm in Texas, so I visited the Mansfield location instead as it was closer for me. The patient care has been nothing short of amazing. In fact, I cant imagine my life without HerKare. I struggled with hormone deficiency since 2003 until March 2018. The treatment plan provided by HerKare has positively impacted my way of life socially, emotionally, and physically. One of my closest friends now drives from Copperas Cove to the Mansfield location. I have several friends in my age group mid to late 40s & early 50s who would benefit from HerKare. I understand with our nation experiencing COVID, now might not be the time to open a new location, however, your services could positively impact the well-being of so many women. When the time is right, please open more HerKare locations!

Patient since March 2018

Menopause & Urinary Symptoms At A Glance:

• These urinary changes occur for two reasons: Menopause reduces the amount of the female hormone estrogen, and a lack of estrogen reduces the urinary tracts ability to control urination. Advanced age, which usually coincides with menopause, also has various debilitating effects on the pelvic area organs and tissues.

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Estradiol Induces Increased Upec Growth

We began by evaluating the effects estradiol had on the growth of CFT073. We found that 5 pg/ml of estradiol significantly increased the growth of CFT073 compared with unstimulated CFT073 . Statistical significance was reached from 8 h onward for 5 pg/ml estradiol. The biggest growth difference was observed between 5 pg/ml estradiol and unstimulated CFT073 after 24 h . However, the higher concentrations of estradiol did not induce a significant growth increase compared with unstimulated CFT073 .

Figure 1. CFT073 growth with or without the presence of estradiol during 24 h and at 24 h . Data are presented as mean and mean ± SEM of n = 3 independent experiments. The asterisk distinguishes statistical significance: ***p< 0.001 vs. unstimulated CFT073.

Estrogen And Urinary Tract Infections

A Urinary Tract Infection is an infection caused by fungi, viruses, and bacteria in the urinary tract. Urination typically washes microbes out of the body, but there are a number of complications that can prevent total cleansing, and result in a UTI. As the second most common type of infection in the body, UTIs account for about 8.1 million visits to the doctor each year. Women are at greatest risk of contracting a UTI, and have more than a 50 % chance of getting a UTI in their lifetime, and a 25% chance of getting a second one within 6 months.

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How Is Low Estrogen Treated

Women who have low levels of estrogen may benefit from hormonal treatment. Hormonal treatment is the standard for low estrogen. There are non-hormonal options to help relieve symptoms. Non-hormonal options are preferred for women at high risk for breast cancer, blood clots, stroke, or liver disease.

What Is Overactive Bladder

Overactive bladder is a health condition an estimated 33 million Americans experience. This condition affects your bladder control and can cause unwanted symptoms that affect everyday life. Overactive bladder is a type of urinary incontinence and is also known as urgency incontinence. OAB is different from stress incontinence, which can cause you to leak urine when theres extra pressure on your bladder, such as when you cough, sneeze, or laugh. Instead, overactive bladder generally means you experience frequent and urgent feeling that you need to pee, often at inconvenient times.

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