Needing to urinate more often?

Leaking? This Can Be One of the Menopause Changes

Incontinence– Menopause Symptom # 9

Urinary incontinence is one of the most common menopause symptoms. urinary incontinence is a symptom of menopause

During the years that precede the onset of menopause, many changes begin to happen in a woman’s body. Some of them are small changes at the beginning that she might chalk up to stress. Women often tell us that they are blindsided by menopause and do not realize that they are in it until they are in the middle of it.

One of the perimenopausal symptoms is the onset of urinary incontinence. You may begin to notice that you need to urinate more often, and start to experience leaking when your bladder is full. You may be too embarrassed to talk about this and wonder what is happening to your body. Often, women will not connect urinary incontinence to menopause problems.

urinary incontinence is a symptom of menopause

What is Menopausal Urinary Incontinence?

Urinary incontinence is a loss of control over the bladder. Mayo Clinic says: “The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.”

When we age, the bladder becomes thinner, causing possible incontinence. This is particularly true for women with some chronic conditions such as diabetes or who suffer from frequent urinary tract infections.

You may find that you experience urine involuntarily leaking when you cough, laugh, exercise or make any movement that puts pressure on your bladder.

Urine is formed in the kidneys and travels through tubes called the ureters into the bladder. The walls of the bladder are not stretched until it fills up. When the bladder fills up, the muscles around it squeeze causing the feeling that you need to urinate. When you are ready to urinate, the muscles squeeze harder to allow the urine to pass through.

With urinary incontinence, this normal function changes.

There are several types of urinary incontinence, but the most relevant to menopause, and caused by the hormonal changes during this time, is stress incontinence.

The pelvic muscles are located beneath the bladder. When the pelvic muscles are weakened, they are not strong enough to deal with the pressure pushing on the full bladder. This can cause stress incontinence.

urinary incontinence is a symptom of menopause

What are the symptoms of urinary incontinence?

Common symptoms of urinary incontinence include:

  • Coughing, sneezing, exercising, or laughing can cause leaking urine
  • Having a sudden uncontrollable need to urinate.
  • Urination more frequently than normal.
  • Needing to wake up several times a night to urinate.
  • Urinating while sleeping.

urinary incontinence is a symptom of menopause

Why does urinary incontinence happen?

Lower estrogen levels:

During perimenopause, estrogen production declines when periods become irregular. At that point, the ovaries produce very little estrogen.

Low estrogen causes both vaginal tissue and the tissues of the urethra (the tube that allows urine from the bladder to exit the body) to become thinner.

Estrogen is a hormone that helps keep the bladder and urethra healthy and functioning normally. As you enter perimenopause, your lower estrogen levels may also cause your pelvic muscles to become weaker and less able to control the bladder. For this reason, as estrogen levels drop further, urinary incontinence may start or worsen.

Aging process:

As women age, their overall muscle strength weakens. This is also true of the pelvic muscles. As mentioned above, weakness in the pelvic muscles can cause incontinence because they are less able to support the bladder and the urethra.

Chronic conditions:

Certain chronic conditions such as diabetes, multiple sclerosis,  Parkinson’s disease, and stroke can worsen urinary incontinence.

urinary incontinence is a symptom of menopause

Is urinary incontinence an inevitability?

The answer is no!

Several stresses on a woman’s body can affect bladder control, such as pregnancy, childbirth, and menopause. This can often be managed with special exercises and other strategies that strengthen or the muscles around the bladder, the urethra, and the vagina.

urinary incontinence is a symptom of menopause

How can I prevent or improve urinary incontinence?

There are several strategies that help with this issue:

1. Kegel Exercises

These are pelvic muscle exercises that help strengthen the muscles that you use to control urination. When these muscles are strong, you are able to ‘hold’ urine in your bladder for longer.

How to do Kegel exercises:

  • Locate the correct muscles: When you stop urinating midstream, you feel and can identify the pelvic floor muscles.
  • Tighten the same muscles you identified as if you are lifting the chair you are sitting on. Do a slow count of three (3 seconds), then relax for a count of three.
  • Focus only on those muscles. Do not tighten your tummy muscles or your thigh muscles or buttocks. Breathe.
  • Repeat 10 to 15 times per session.
  • Repeat these exercises 3 times a day.
  • Don’t do the exercises while urinating, as this may increase the risk of urinary tract infection.

Expect results within a few weeks or even months. As with all other exercise, it takes time to strengthen the muscles. Be persistent and it will pay off. Make the Kegels a habit you practice daily.

2. Decrease beverages such as tea and coffee

Drinking too many fluids fills up the bladder and can cause more frequent urination.

3. Check your medications

Certain medications can increase the risk of urinary incontinence, such as diuretics and steroids. Check with your physician.

4. Fight constipation

Constipation can cause stress on the bladder and weaken your pelvic floor muscles. Make sure you have enough fiber in your diet to prevent constipation.

5. Keep a healthy weight

Excess weight can put extra pressure on your bladder and cause urinary incontinence or make it worse. Try to eat healthy and exercise. Read more about how you can control weight here.

6. Speak with your doctor

Your doctor can suggest a number of strategies that may include:

  • Certain medications that increase the amount of urine that your bladder holds. Your doctor may prescribe a topical estrogen cream that may help improve the thickness of the urethra walls. Please ensure that you discuss with your physician all possible risks of using any medication before opting to do so.
  • Nerve stimulation: An electrical stimulation to strengthen the pelvic floor muscles if the cause is nerve impairment.
  • Devices: The most common is a device inserted in the vagina to help position the urethra to reduce urine leakage.
  • Surgery: This is the last resort to help reposition the bladder.

Obviously, it is a good idea to try strengthening your pelvic floor muscles to help prevent or treat incontinence before going for the more involved treatments.

Urinary incontinence is more likely as we age and as we go through menopause, but it is not an inevitability if it is addressed early on. Please do your Kegel’s every day. The benefits extend beyond bladder control to stronger vaginal muscles and prevention of prolapse.

urinary incontinence is a symptom of menopause

Read more about perimenopause symptoms here:

Hot flashes



Mood Swings

Night Sweats

Brain Fog

Irregular Periods

Weight Gain

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