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Menopause and Incontinence: Why It Happens and How to Regain Control

Menopause is a trying time in a woman’s life when it may seem as though she loses control of various areas of her body. From hot flashes and brain fog to mood swings, and then there’s incontinence, where you lose control of your bladder and even sometimes your bowels.

Men can get urinary incontinence too, but it affects women twice as often, with around 20–30 per cent of young women, 30–40 per cent of middle aged women and up to 50 per cent of older women experiencing it.

This article will discuss incontinence in older women and, in particular, incontinence during menopause. Know what you’re looking for? Jump there now:

• Can Incontinence Be a Symptom of Menopause?
• Why Does Menopause Cause Incontinence?
• How Do You Treat Perimenopause Incontinence?
• FAQs

Further Reading: All About Menopause

Can Incontinence Be a Symptom of Menopause?

Menopause can lead to hormonal changes, especially lower oestrogen levels, which may cause osteoporosis and various other symptoms like hot flashes, night sweats, mood swings, joint pain and vaginal dryness. Another common issue during menopause is urinary incontinence (UI), affecting over half of postmenopausal women. Factors like a sedentary lifestyle, lack of exercise and ageing muscles make the problem worse.

UI is a major concern as it disrupts daily activities, physical exercise and intimate relationships. It's also a key symptom of Genitourinary Syndrome of Menopause (GSM), which includes vaginal dryness, discomfort during sex and a decrease in sexual desire.

Further Reading: How NMN May Help Menopausal Symptoms

Why Does Menopause Cause Incontinence?

Menopause can cause urinary incontinence due to:

1. Low Oestrogen: Thins the urethra lining.
2. Weak PelvicMuscles: Leads to frequent urination and less control.
3. Vaginal Dryness: Increases UTI risk.
4. Bladder Changes: Loss of elasticity causes more frequent urination. Menopause and frequent urination at night are common.
5. Weight Gain: Puts extra pressure on the pelvic floor, reducing bladder control.

Menopausal women are also more prone to urinary issues like UTIs. Untreated incontinence can lead to more UTIs, skin problems, reduced sexual interest and mental health issues like depression.

How Do You Treat Perimenopause Incontinence?

You might want to look into a menopause incontinence treatment to reduce symptoms and improve your quality of life as you go through menopause.

Here are a few urine leakage treatment ideas to help you during menopause:

1. Pelvic Floor Exercises (Kegel Exercises): Pelvic floor incontinence exercises help strengthen muscles to improve bladder control. As for how to strengthen pelvic floor during menopause, try clenching and releasing pelvic muscles while sitting or lying down, repeating 10 times.
2. Medications: Speak to your doctor to see if duloxetine (for stress incontinence), antimuscarinics/mirabegron (for urge incontinence) or desmopressin/diuretics (for nighttime urination (nocturia)), may work for you. Vaginal estriol cream for bladder problems may also reduce stress urinary incontinence in postmenopausal women.
3. Maintain a Healthy Weight: Weight loss through diet and exercise can reduce symptoms.
4. Incontinence Treatment Surgery (if needed):
   • Colposuspension: Lifts bladder neck to prevent leaks.
   • Sling Surgery: Supports bladder neck with a sling.
   • Vaginal Mesh: Provides support to the urethra.
   • Urethral Bulking: Injections to strengthen urethra walls.
   • Nerve Stimulation: Helps control bladder urges.
   • Catheterisation: For severe overflow incontinence.

Further Reading: How Menopause Affects Your Muscles

FAQs

Why can’t I hold my pee all of a sudden?

If you suddenly struggle to hold your pee, it might be due to weakened pelvic floor muscles, which help control the bladder. Hormonal changes, especially during menopause, can also play a big role. As oestrogen levels drop, the muscles and tissues around the bladder and urethra may weaken, making it harder to hold in urine. Conditions like urinary tract infections (UTIs), bladder irritations or stress incontinence (caused by sneezing, coughing or laughing) can also cause sudden leaks.

Can hormonal changes cause incontinence?

Yes, hormonal changes, particularly a drop in oestrogen during menopause, can lead to urinary incontinence. Oestrogen helps keep the tissues of the bladder and urethra healthy and strong. When oestrogen levels decline, these tissues can become weaker and thinner, reducing bladder control. Hormonal shifts can also disrupt the balance of signals sent to the bladder, causing more frequent urges to urinate or unexpected leakage.

Can menopause cause bowel leakage?

Yes, menopause can lead to changes in bowel habits, including bowel incontinence. The drop in oestrogen weakens not only the pelvic floor muscles that support the bladder but also those that control the bowel. This muscle weakening can make it harder to control bowel movements, leading to leakage. Hormonal changes can also affect the digestive system, causing constipation or diarrhea, which may increase the risk of accidental bowel leakage.

What hormone causes frequent urination?

Oestrogen is the key hormone that, when decreased during menopause, can contribute to frequent urination. Oestrogen helps maintain the strength and flexibility of the tissues in the bladder and urethra. When oestrogen levels drop, these tissues can become less elastic and more sensitive, leading to an overactive bladder. This can cause a frequent, urgent need to urinate, even if the bladder isn’t full.

Does lack of oestrogen cause incontinence?

Yes, a lack of oestrogen is a significant factor in causing incontinence. Oestrogen is important for maintaining the strength and health of the pelvic floor muscles, bladder and urethra. During menopause, when oestrogen levels decline, these muscles and tissues can weaken. This makes it harder to control urine flow, leading to stress incontinence (leaks during activities that increase abdominal pressure) or urge incontinence (sudden, intense urges to urinate).

Does menopause incontinence go away?

Menopause-related incontinence can improve with treatment, but it may not go away entirely without proper management. Lifestyle changes like losing weight, avoiding bladder irritants (like caffeine) and doing pelvic floor exercises (Kegels) can help strengthen the muscles and reduce symptoms. Medications may also be prescribed to help control bladder urges or relax the bladder muscles. In more severe cases, treatments like hormone replacement therapy (HRT) or surgical options may be considered. The key is to address the issue early and follow a tailored treatment plan to manage and reduce symptoms effectively.

Will HRT help with incontinence?

Hormone Replacement Therapy (HRT) may help with incontinence, especially for menopausal women. HRT boosts oestrogen levels, which can strengthen the tissues around the bladder and urethra. This may improve bladder control and reduce symptoms like frequent urination or unexpected leaks. Keep in mind that it’s not a guaranteed fix for everyone. The effectiveness of HRT varies and some women may still need additional treatments like pelvic floor exercises or medications to fully manage incontinence. It’s best to talk to a doctor to see if HRT is a suitable option for you.

Further Reading: Foods to Avoid During Menopause

End Note

If you’re experiencing urinary incontinence, it’s best to address it early to maintain your quality of life for as long as possible. Start with pelvic floor exercises and, if needed, speak to your doctor about medications or surgery.

If you are experiencing UI, know that you’re not alone! Keep up to date about your health and ways to improve your health with our blogs.