What role does menopause play in urinary incontinence, what proportion of women are affected, and how does pelvic floor training compare with surgical options?
Hello, this is Mr. Hotsia.
I am 56 years old. I’m writing this from my home in Chiang Rai, in northern Thailand. For 30 of those 56 years, my “job” was to be on the road. My life’s work, as you might know from my YouTube channels or my website, Hotsia.com, was to travel to every single province of Thailand, Laos, Cambodia, Vietnam, and Myanmar.
My “research method” was living. I ate with the locals. I sat with the 60- and 70-year-old grandmothers. I watched them work, laugh, and live.
And in 30 years, you see the “ground truth” of suffering. I’ve seen the visible suffering: the knees worn out from a lifetime of planting rice, the backs bent from hard labor. But there is a second suffering. A hidden suffering. The suffering that isn’t talked about over the khao soi (Chiang Mai noodles).
Now, I live a second life. I’m a systems analyst by training. Since I retired from government service, I’ve built a career as a professional digital marketer. It’s a job that earned me a ClickBank Platinum Award in 2022.
My new job is to analyze data. I run over 40 websites , and I research the “high intent keywords” of a US audience. I see what they fear. And the fear I see in the data is explosive: “menopause and leaking when I laugh.” “why do I pee when I sneeze.” “I can’t run anymore.”
My “ground truth” (the hidden suffering) and my “data” (the open fear) have collided. This is a systems failure. As a systems analyst, I had to understand why.
💧 The “System Failure” (Why Menopause Causes This)
First, my “systems analyst” brain. This is not “getting old.” This is a systems failure. The problem is that the “master signal” (Estrogen) is gone.
Estrogen is not just for “babies.” It is the master signal that runs the “background systems” in a woman’s body. It keeps tissue plump, elastic, and strong. When that “signal” stops… the “system” panics.
In the urinary system, this “panic” is a 3-part disaster:
- The “Hammock” (The Pelvic Floor): This is the “ground truth.” This is the muscle that holds everything up (the bladder, the uterus). Estrogen helps keep this “hammock” strong. When the signal is gone, the “hammock” sags.
- The “Pipes” (The Urethra): The “signal” (Estrogen) keeps the lining of the “pipes” (the urethra) thick and sealed. When the signal is gone, the “pipes” get thin, dry, and weak (atrophy). They can’t “seal” anymore.
- The “Signal” (The Nerves): The nerves that tell the bladder to “hold on” or “panic” are also affected by this “system failure.”
This is the systems failure. The “hammock” (muscles) sags, the “pipes” (urethra) can’t seal, and the “signals” (nerves) get panicky. This is why a simple cough or laugh (a “stress”) is now enough to break the “system.”
📊 The “Data”: What Percentage Develops Gum Disease?
This is the “data analyst” question. What is the real number? My “ground truth” (watching the “new sickness” of a sedentary lifestyle) makes me think 100%.
But the “data” (the clinical studies) is more precise. The “data” is blurry because this is hidden. But the studies (from the NAFC and other journals) show the numbers are huge. The “data” is: Up to 50% of postmenopausal women will have some form of Urinary Incontinence (UI).
But as a “systems analyst” and a “traveler,” this is my “ground truth” take: The number is irrelevant. The “ground truth” is that the “new sickness” (a high-sugar, inflammatory lifestyle + a sedentary life) + the “system failure” (menopause) = a 100% guarantee of problems… if you do nothing.
🏋️♀️ The “Ground Truth” vs. The “Data” Fix (Training vs. Surgery)
This is the core of the problem. This is what my “ClickBank” audience is confused about. “What one thing do I do?” This is “single-part” thinking. It is wrong.
1. The “Ground Truth” Fix (Pelvic Floor Training)
- What it is: Kegels. But real Kegels. This is a Pelvic Floor Muscle Training (PFMT) program.
- My “Systems Analysis”: This is the “Ground Truth” fix. This is the “old way” of work. My 30 years of travel have shown me that the body adapts to work. This is work.
- The “Data”: This is a “systems fix.” You are not “patching” the system. You are re-building the “hammock” . You are forcing the system to get strong again.
- The “System Failure”: This is hard. It takes months. It’s not a “quick fix.”
2. The “Data” Fix (Surgical Options)
- What it is: A “patch.” A technical solution.
- My “Systems Analysis”: This is the “systems analyst” in me. This is the “new way.”
- The “Sling” (For Stress Incontinence): This is the most brilliant “patch.” The “hammock” (muscle) has failed? The “systems analyst” (surgeon) installs a new “support beam” (a mesh sling) under the “pipe” (urethra). It’s a technical fix for a mechanical problem. It works.
- Botox (For Urge Incontinence): The “system” is “panicky” (the UUI)? The “analyst” injects Botox to paralyze the “panic” signal. It’s a “signal fix.”
📊 Table 1: Mr. Hotsia’s “Systems Analysis” (The “Fixes” Compared)
As a systems analyst, I log the data.
⚖️ The “Risk” vs. “Reward” (The “Analyst’s” Log)
Here is my “field guide” as both an analyst and a traveler.
🌏 A Traveler’s Final Word: The “System” is the “Ground Truth”
I am 56 years old. I’ve seen the “old way” and I’ve analyzed the “new data.” And here is my final analysis.
My “data” (my US keyword research) shows people want one fix. A pill or a surgery. My “ground truth” (my 30 years of travel) shows the “old way” was work.
The “new sickness” (a sedentary life, obesity) is an accelerant. The “system failure” (menopause) is the trigger.
You cannot “patch” (surgery) a “system” that is under attack from a bad lifestyle. You must fix the load (Lifestyle) first. Then, you must try to re-build the “system” (Pelvic Floor Training).
Only then—when the “system” is too broken to “re-build”—do you use the “data” (the surgery). The “data” is the “patch.” The “ground truth” is the work. And the “work” is the real “fix.”
🙋♂️ My Research FAQ (Frequently Asked Questions)
1. Is this permanent? Or will it go away? My “systems analyst” answer: It is a systems failure. It will not “go away.” The “signal” (Estrogen) is gone. The system (the “hammock”) is weak. You must intervene with a “fix” (Training, Lifestyle, or Surgery).
2. I’m 60 (like the women you met). Is it “too late” for the “Training”? My “ground truth” (as a 56-year-old traveler) says: No. It is never “too late” to work. The data (the studies) proves it. A 60- or 70-year-old “hammock” can get stronger. It is harder, but it is not impossible.
3. What about those “vaginal weights” I see in my “data” (ads)? My “systems analyst” (and ClickBank marketer) brain loves this. This is a “tool.” It’s like a dumbbell for your “hammock.” It’s part of the “Training” (“Ground Truth”) fix. It’s a good “tool” to help the “work.”
4. Can I just lose weight? (My “Lifestyle” fix). My “data” answer: It is the best “Step One.” The data is clear: A 10% weight loss can cut “leaking” (SUI) by 50%. You are reducing the load on the “sinking hammock.” It is the most powerful “fix” you can do today.
5. I’m 56 (like you, Mr. Hotsia). What’s the #1 thing I should do? My “systems analyst” and “traveler” answer: See a “systems analyst” (a real Urogynecologist). Get the real “data.” Why is your “system” failing? Is it the “hammock” (SUI) or the “signal” (UUI)? You cannot “fix” the “system” until you know which part is broken.
I’m Mr.Hotsia, sharing 30 years of travel experiences with readers worldwide. This review is based on my personal journey and what I’ve learned along the way. Learn more |