Does Perimenopause Cause Incontinence and Bladder Leakage?
By Ashley Nowe
Published:
Are you suddenly and frequently rushing to the bathroom with that “gotta go right now” urgency? Perhaps you leak a little bit when you sneeze.
Menopause and urinary incontinence are just a part of aging… an annoying and possibly embarrassing part of aging… right?
Wrong.
Is Incontinence a Normal Part of Perimenopause?
No. Incontinence is a common symptom of menopause/perimenopause – up to 60 percent of perimenopausal women experience some level of incontinence. But it isn’t normal.
So why does it seem like menopause and frequent urination go hand-in-hand, anyway? Several factors can result in urinary incontinence, from prolapse to perimenopause. And as most peri symptoms do, it boils down to the loss of estrogen. Estrogen impacts just about every system of the body, and genitourinary symptoms are a common issue in perimenopause.
Less estrogen leads to the loss of elasticity of vaginial tissue, vaginal dryness, and weaker pelvic floor muscles. Your chances of leaking increase when your pelvic floor and vulvar tissue are compromised.
Types of Urinary Incontinence
The loss of estrogen can contribute to the two main types of incontinence: stress incontinence and urge incontinence.
- Stress incontinence occurs when pressure from an activity puts pressure on your bladder. If you have weak(ened) pelvic floor muscles, they can’t properly support your bladder. Anything that puts pressure on your bladder, from sneezing and coughing to running can cause you to leak urine.
- Urge incontinence occurs when you suddenly feel an intense urge to urinate followed by leakage. This is due primarily to hormonal shifts. Low estrogen levels can cause your bladder muscles to become irritated and/or overactive.
A third issue can lead to incontinence: pelvic organ prolapse. Studies suggest that about 90% of women who give birth experience some degree of pelvic organ prolapse. During pregnancy, the muscles and tissues that support your pelvic area can weaken and stretch. This may cause one or more pelvic organs to sag or stick out into the vagina. This can lead to leakage and incontinence symptoms.
Prolapse can also occur if someone is dealing with:
- Chronic constipation/straining during bowel movements
- Chronic coughing
- Heavy lifting without proper core engagement
- Menopause (That’s what we’re here for, isn’t it?)
Again, just because it’s common, doesn’t mean it’s normal to experience incontinence.
No one wants to go through life concerned about leaking.
How to Improve Incontinence Symptoms
Fortunately, there are many options to help treat urinary urgency symptoms. They can dramatically improve your quality of life.
1. Strengthen your core and pelvic floor
Focus on engaging your core to better manage intra-abdominal pressure. Your core and pelvic floor work together – like a piston engine firing. As you inhale, it pushes your diaphragm and pelvic muscles down. Exhaling pulls everything back up and in.
Ann Collins Duch, pelvic floor physical therapist, explains the importance of core engagement here:
Check out Core Basics in the Menovation app to learn more about supporting pelvic health and strengthening the pelvic floor.
2. Topical Estrogen Cream
According to Anne, applying a topical vaginal estrogen cream can improve tissue elasticity and help with perimenopause incontinence. Maintaining hormone balance through hormone replacement therapy can improve the health and function of the urinary tract.
Hear more about the many benefits of estrogen cream:
3. Lifestyle Changes
Maintaining a healthy weight and active lifestyle will certainly have a positive impact on incontinence symptoms. Other lifestyle tweaks can include:
- Avoid Bladder Stimulants: Bladder stimulants, like coffee and alcohol, can be a doozy for those experiencing incontinence symptoms. Try modifying your intake. This might also mean limiting beverage intake before bed, long drives, or times you won’t have immediate access to a bathroom.
- Avoid Certain Processed Foods: Certain foods, like sugar, artificial sweeteners, and spicy foods, can cause irritation. Try to keep track and see if you notice symptoms worsen when you consume certain ingredients.
- Bladder Training: Schedule regular bathroom breaks. Training your bladder to go on a regular basis can help improve continence (bladder control).
4. Pelvic Floor Therapy
Pelvic floor physical therapy is not just for recently postpartum women. Many women struggle with bladder control in menopause, and pelvic floor PTs focus on strengthening and improving the function of pelvic muscles. This ties directly to bladder and bowel control.
A PT can also diagnose and address underlying issues, such as a weak core or muscle imbalance that is impacting your continence.
The National Association for Continence further breaks down these treatment options for managing incontinence in menopause.
What to Do While Working on Incontinence Symptoms
It takes time and effort (e.g. doing specific exercises) to improve incontinence symptoms. There’s no shame in using products, like reusable incontinence underwear, liners, or pads as you work on improving symptoms.
Here are a few options for comfortable, discreet, and washable leak-proof underwear in a range of styles, colors, and sizes:
When to Talk with Your Doctor
If you’re experiencing moderate or severe leakage or genitourinary symptoms, talk with your doctor. There are medications and surgical options for severe cases.
How Menovation Can Help
In the meantime, we are here at Menovation to help support and empower you through your perimenopause anxiety issues and beyond. It features exercises, nutrition plans, and education for improved well-being, reduced symptoms, and inspiring self-care for confidence and vitality. Then tell a friend – we are trying to keep the lines of communication about peri(menopause) open, right?
As always, talk to a doctor or mental health professional about your experience. Be sure to reach out to a professional for additional support, especially if you are experiencing severe symptoms, want to explore hormone therapy, or have other health concerns.
Take the “What stage am I in?” quiz here to determine what stage of perimenopause or menopause you are in and receive a free guide to help you feel your best during that time!
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