The deficiency and consumptive damage of kidney qi and deficiency cold of lower origin mentioned in Donguibogam can be explained in modern medical terms through several complex factors. Entering the climacteric brings a sharp decline in estrogen, a female sex hormone, and this estrogen plays a crucial role in maintaining the health of the tissues around the urinary bladder and urethra.
When estrogen is abundant, the bladder wall is supple and moist, allowing it to store urine smoothly and contract only when necessary. During the climacteric, however, estrogen deficiency causes the mucosa of the bladder wall to thin and dry out, leading to reduced elasticity. Like a deflated balloon, it becomes easily irritated and sensitive with even a small amount of urine. Furthermore, sensory nerves around the urinary bladder react more hypersensitively, sending a strong signal that you must go to the bathroom even when the urine volume is modest. This is one of the key causes of what modern medicine calls overactive bladder.
Moreover, the decrease in estrogen can lead to weakening of the pelvic floor muscles that support the urinary bladder. These pelvic floor muscles are essential for preventing urine leakage and holding the urinary bladder firmly in place. When these muscles weaken, stress urinary incontinence easily occurs, where urine leaks upon coughing or laughing. This is why frequent urination and urinary incontinence often appear together. This closely aligns with Donguibogam's concept of unconsolidation of bladder qi, which refers to a urinary bladder that is not firm.
Neurological factors cannot be overlooked either. The brain and urinary bladder are very closely connected. During the climacteric, autonomic nervous system balance is easily disrupted. When psychological factors such as stress or anxiety are added, they can affect the nervous system that regulates excessive bladder activity, worsening frequent urination symptoms. It is as if the brain commands the urinary bladder too often to empty right away.
Of course, frequent urination might not stem solely from the climacteric. It can also be a sign of conditions such as urinary tract infections, diabetes, diuretic use, or, rarely, bladder cancer. Therefore, if there is pain during urination or blood in the urine, you should receive an accurate diagnosis at a clinic. Still, please remember that many women entering the climacteric experience frequent urination due to these hormonal shifts, muscle weakness, and nervous system imbalances. Understanding and caring for the changes in our bodies is truly important.
