Menopause and the Bladder

Perimenopause bladder problems such as urinary incontinence can mean worrying about leaks when you cough, sneeze, laugh, exercise, or - for a quarter of women with incontinence – even when you have sex!

Research has estimated that in the UK 9.6 million women experience bladder issues that affect nearly 1 in 5 of the over-40 population. And an unbelievable 42% of women affected wait up to 15 years before seeking help. We don’t want you to be one of them, believe us when we say that leaking is preventable and it can be stopped.

What causes menopause incontinence?

Oestrogen helps to keep the bladder and urethra - the tube that passes urine from the bladder out of the body - healthy and functioning properly. Nearing menopause, your oestrogen levels begin to drop causing pelvic floor muscle weakness and thinning of the urethra. Menopause urinary incontinence (UI) symptoms increase as oestrogen levels continue to fall.

Caused by weak pelvic floor muscles, stress incontinence – leaking urine when you laugh, cough or sneeze - is more common in perimenopause. Other types of incontinence include: urge when an overactive bladder means urine leaks as you feel a sudden intense need for the loo and overflow incontinence when you can’t fully empty your bladder so it fills up again and overflows. Some women experience both stress and urge incontinence.

If symptoms don’t improve after lifestyle, exercise and diet changes, prescription medications, including botox, may help to calm muscle spasms in the bladder.

Treatments for menopause bladder problems

Leaking is very common but isn’t something anyone should put up with, be reassured it can be solved in 85% of cases. Why put up with a lifetime of pads and post-menopause urinary tract infections (UTIs) when there are treatments that can help stop the leaks?

If leaking is becoming increasingly worse, ask your doctor if they can refer you to a specialist women’s pelvic health physiotherapist. Physios work in the NHS and in private practice. Research has shown that pelvic floor muscle training through specialist physios is cheaper and more effective than one of the main incontinence drugs. Other research compared non-surgical treatments. This found that intensive pelvic floor muscle training, plus lifestyle changes, was the most effective method for treating incontinence. 

Surgery may be an option to discuss with your doctor, although the recent advice is to see a physio first.

If you are affected by incontinence, pelvic health campaigners #PelvicRoar has a comprehensive website that provides a list of resources that may be helpful.

Find a menopause trained Women’s health physio

Our sister business Menopause Movement has trained many women’s health physios and fitness professionals, who are experts at solving incontinence issues and will be able to teach you how to do your pelvic floor exercises correctly in a safe, friendly environment.

Find one in your area by checking the Menopause Movement directory.

Menopause and bladder infections

It’s thought that around two-thirds of women experience a bladder infection at some point in their life. Studies estimate that about a third of women have recurrent urine infections and incontinence related to menopause, and the frequency increases with age.

Urinary tract infections (UTIs), are a common post-menopause symptom and cause pain and burning while passing urine. Caused by low oestrogen levels the urethra can become more delicate and prone to bacterial infection in the wall of the bladder.

Talk to your doctor, they can carry out a urine test or send a sample to the lab to check for bacteria. Some mild bladder infections will get better by themselves if you drink plenty of fluid, but some may require a course of antibiotics, especially if the infection is making you feel unwell or have a fever.

If you have recurrent bladder infections you may need a low-dose antibiotic to keep them at bay.

HRT and bladder problems, does it help?

Oestrogen preparations have been used for many years to manage urinary symptoms, but there is still controversy over the efficacy of these preparations.

Vaginal oestriol significantly reduces the risk of recurrent infections in post-menopausal women with a history of recurrent urinary tract infections.

Where bladder symptoms are caused by urogenital atrophy (changes in the tissue of your bladder, urethra and vagina caused by lack of oestrogen), you may be offered HRT. HRT contains oestrogen, which helps improve the bladder and urethral tissues that have been made more delicate by menopause. This can also help prevent bladder infections.

Can HRT help incontinence?

Not necessarily for urinary incontinence. Stress incontinence is a possible side effect of HRT. Studies show that whilst bladder control improves for some women it may deteriorate for other women. Essential to talk to your doctor about this. 

And the good news is….

In 85% of cases of incontinence caused by pelvic floor weakness can be improved by appropriate pelvic floor exercises. You’ve nothing to lose by trying out our simple self-help solutions and plenty to gain!

Making changes to your diet and lifestyle, and doing the correct pelvic floor exercises daily, by maintaining a good level of fitness, could help you to improve bladder issues.