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Whether it’s needing to go more often or accidentally weeing yourself, urinary incontinence is really common during perimenopause and menopause — but it’s definitely not spoken about enough.
Some signs you may be experiencing incontinence during menopause are:
Leaking urine when you cough, sneeze, laugh or exercise (stress incontinence)
Feeling a sudden, intense need to pass urine (urge incontinence or overactive bladder)
getting up often during the night to pass urine (nocturia)
frequent urinary tract infections (UTIs)
Although incontinence is often a byproduct of menopause, bladder leaks don’t have to be a “normal part of ageing”. Just because menopause is unavoidable doesn’t mean you have to suffer the symptoms in silence.
Keep reading to learn more about incontinence, why it’s common in menopause, and how you can manage bladder leaks.
Why does menopause make your bladder weak?
During perimenopause and menopause, your body naturally stops producing the hormone oestrogen.
Oestrogen plays a key role in the health of your urinary and reproductive systems. The vagina, vulva, and urinary tract are packed with estrogen receptors, so as oestrogen levels drop your pelvic organs can really suffer. Declining estrogen can mean that:
The lining of your bladder and urethra become thinner and less elastic
Pelvic floor muscles become weaker
Vaginal tissues become thinner, drier and less elastic
As the lining of your bladder and urinary tract become thinner and your pelvic floor weakens, it becomes harder to hold in urine, making you more susceptible to bladder leaks.
Declining levels of estrogen can cause other problems, such as:
Pelvic organ prolapse. This is when the muscles in your pelvic floor weaken, causing the uterus or bladder to move out of place and bulge on your vaginal wall.
UTIs. Lower levels of estrogen can thin the lining of your vagina and urinary tract, making it more susceptible to harmful bacteria. It can also affect your vaginal pH, making your urinary tract more vulnerable to infection-causing bacteria.
Vaginal atrophy. This is when the lining of the vagina becomes thinner, less elastic and loses its natural lubrication. Vaginal atrophy can cause pain and discomfort, especially during sex.
Treatment for urinary incontinence during menopause
Bladder leaks don’t have to be an inevitable part of ageing, regardless of their severity.
Luckily, there are plenty of things you can do to improve bladder control during perimenopause and menopause.
Bladder training
Bladder training is a type of behaviour therapy done with the help of a specially trained expert used to treat incontinence.
Bladder training teaches you to gradually hold in pee to prevent unwanted leaks.
Pelvic floor exercises
Pelvic floor exercises can be done from the comfort of your own home, without the supervision of a doctor. Check out our expert tips on how to strengthen your pelvic floor muscles.
Medication
Oxybutynin, mirabegron and Botox (yes, you read that correctly!) help your bladder relax and stop it from being overactive. However, medication can have undesired side-effects and should be a last resort to be considered under medical supervision and only after having first explored natural remedies.
Lifestyle changes
Small changes like eating more fibre, staying hydrated, cutting back on bladder irritants (like caffeine, alcohol, and artificial sweeteners) and exercising regularly can all help improve bladder health.
Oh, and proper peeing etiquette is essential, too!
Hormone replacement therapy (HRT)
Although HRT is not usually prescribed as a treatment for incontinence, speak to your doctor about HRT if you’re experiencing other bothersome symptoms of menopause, like hot flashes or vaginal dryness.
Surgery
In very rare cases, procedures like mesh surgery or sling surgery may be considered when other treatment options haven’t worked.
