Menopause and Incontinence - What Happens During Menopause?

As if all the hormonal changes weren’t enough, the menopause may also bring the unwelcome gift of a weakened pelvic floor which can result in urinary incontinence (or bladder leaks as they are otherwise known). This issue directly impacts lots of women who are going through ‘the change’ aka - menopause and we want you to know that you are not alone.

Some women think that urinary incontinence is a given and something they should simply expect to deal with as they get older, but it is not an inevitable part of the aging process and there are steps you can take to prevent and treat urinary incontinence triggered by the menopause.

So how can menopause cause urinary incontinence? Bladder weakness tends to start in the perimenopause stage; this is where estrogen levels drop, causing the urethral and vaginal tissues to thin, paired with the fact that pelvic floor muscles can start to relax as we age - this can lead to urinary incontinence.

This blog post covers facts and information related to menopause incontinence, plus other things that women should know as they approach menopause.

You may start to experience leaks when you laugh, cough, sneeze or exercise

Some women breeze through pregnancy and perimenopause without experiencing any type of bladder weakness. But then menopause hits and these women find that their oversized handbag is now stocked with an assortment of pads and extra underwear.

Your body shape can change

"A lot of women come into my office and say they're gaining weight in their midsection, can't lose it, and they don't know why," says Keri Peterson, MD, a physician at Lenox Hill Hospital in New York City who works with ZocDoc. "What they don't realize is that when their hormones change as drastically as they can in menopause, their body changes—and so their fitness routines need to as well."

So, if you're someone who has always been a cardio queen and skimped on the weight training, now's the time to finally give that bootcamp class a whirl. Not only will it help slim down your shape, but Dr. Peterson says it'll help build bone mass, which is increasingly important for women as they age.

You may start to leak or feel pain during sex

Experiencing pain during sex is a common complaint associated with menopause, but we're here to tell you that your sexual pleasure meter is not doomed from here on out. Yes, it's possible for sex to be painful—that's because when you hit menopause, the estrogen levels in your body drop dramatically. "Estrogen fills the epithelium, or your vaginal lining, so when estrogen decreases, that vaginal lining thins out," says Wulf Utian, MD, founder and medical director for the North American Menopause Society. "When intercourse happens, those surface cells that are very thin get wiped off, and the nerve endings become exposed and can cause pain."

But here's the good news: it's a "use it or lose it" situation, explains Dr. Utian. "If the woman is in an active sexual relationship, and continues that way, that often causes the vaginal lining to protect itself because you're using it and it's being stimulated," he says. "It's like when a callus develops on your hand when you play tennis—the skin builds up a protective barrier because you're using it."

That said, if you're having sex regularly and still experiencing pain (and didn't have a long hiatus), Dr. Utian says you may just need an extra dose of estrogen to help alleviate the problem, so schedule a visit with your OB/GYN to chat about your options.

Aside from dealing with pain during sex, menopause can also trigger urinary leakage during intercourse.

Leaking during intercourse is estimated to affect up to a quarter of women with incontinence. This can be an embarrassing issue that not only impacts a woman’s confidence, but many women feel unable to relax and enjoy sex, and can resort to avoiding sex altogether, which then affects their sex life.

There is a solution for urinary incontinence and no woman should have to deal with this or consider it a natural part of growing older.

You can still get pregnant during perimenopause

Of course, you can't get pregnant once you've hit menopause—which is technically not until the time when you haven't had a menstrual cycle for 12 months, marking the end of fertility—but it is definitely possible during perimenopause.

Perimenopause happens right before menopause, and while it's still extremely difficult to get pregnant then, Tara Allmen, MD, a National Certified Menopause Practitioner in New York City, says you're not out of the child-bearing woods until you've reached the full menopausal stage (when ovaries stop releasing eggs). So, if you're not there quite yet, and don't want any(more) children, make sure you're using protection.

It might not be menopause causing urinary incontinence

Menopause is not the only thing that could be causing your urinary incontinence (UI). The following problems or situations can increase your risk of leaks:

  • Alcohol and caffeinated drinks fill your bladder quickly, making you urinate frequently.
  • Being overweight increases the risk of urinary incontinence as the extra weight puts pressure on your bladder
  • Chronic constipation weakens pelvic floor muscles, which can lead to urinary incontinence
  • Infections in the urinary tract can cause urinary incontinence, but symptoms should clear up after treatment
  • Medications like steroids and diuretics
  • Nerve damage can interfere with signals from your bladder to your brain and you don’t feel any urge to urinate leading to UI

    Treating and preventing menopause related urinary incontinence

    Stay Hydrated

    Dehydration can exacerbate menopause symptoms. Drinking the daily recommended amount of water and avoiding drinks like tea, coffee, alcohol and soft drinks can help to promote healthy bladder activity.

    Exercise Regularly

    Leaks may put you off exercising, but it’s vital that you maintain a healthy weight by having an active lifestyle. Depending on how severe your symptoms are, you could consider low impact exercises, like yoga, pilates, walking or weight training.

    Tone Your Pelvic Floor

    The secret to really improving bladder control is to strengthen and tone your pelvic floor muscles.

    You can do this yourself by completing kegel exercises - which involves clenching and releasing this internal muscle (a bit like holding in a wee), but you’ll need to do hundreds of these each day to see the benefit. That’s where INNOVO can help.

    How can INNOVO help to treat menopause related urinary incontinence?

    INNOVO takes the effort out of strengthening your pelvic floor muscles. Our solution is easy to use, comfortable to wear, and clinically proven to work, eliminating bladder leaks in 12 weeks of less. There are no probes to insert and no doctor visits needed.

    Discover how INNOVO works.