Dr Katherine Penrose
Biography:
Katie Penrose is a local UWA graduate who works as a general Gynaecologist in public and private with a special interest in pelvic floor dysfunction. She works primarily in private practice at SJOG Murdoch and maintains a public appointment at KEMH. Katie has been integral in establishing an outreach Gynaecology and Colposcopy clinic at Derbarl Yerrigan Health Service to improve access to care for Indigenous women. She works with Curtin University as their Clinical Dean at KEMH to help train the next generation of doctors. Outside of work she is a proud mum of three with a passion for Open Water Swimming.
Abstract:
Bladder dysfunction affects the majority of women at some stage in their life, with prevalence significantly increasing in the midlife. Bladder dysfunction, and incontinence in particular, has a detrimental effect on quality of life including sexual function and overall well-being for many women. Symptoms often fluctuate throughout the late reproductive, perimenopausal and menopausal years.
There is debate as to whether the timing of symptom onset in the midlife relates to age, ovarian senescence, or confounding factors such as weight gain in peri-menopause. The widespread existence of oestrogen and progesterone receptors in the urogenital tract provide physiological plausibility for the use of hormonal therapies in the treatment of bladder symptoms. However, the relationship is not straightforward, with meta-analysis concluding that systemic HRT worsens incontinence, whilst local vaginal oestrogens can improve bladder function and overactive bladder symptoms in particular.
Management of bladder dysfunction in the midlife must be tailored to a woman’s reproductive stage as well as other contributory factors, such as weight gain, prolapse, constipation and fluid intake. The evidence for each treatment modality will be explored, with specific emphasis on those most relevant to, and effective for, the years surrounding the menopausal transition.