Menopause and Urinary Incontinence

Menopause and Urinary Incontinence

Are you going through the menopause?

Have you opened and stood next to the freezer door to cool off during a hot flush or wondered where you’ve placed your keys for the hundredth time that day? What about bladder leaks? Are you finding that you’re running to the loo or leaking when you laugh, run, cough, or sneeze?

In this blog, we’re going to focus on the link between the menopause and urinary incontinence. We’ll also chat about the various options that are available to treat it. So let’s jump right in.

Why does menopause cause incontinence?

Before we can understand why menopause causes urinary incontinence (bladder leaks), we need to rewind and understand the role that oestrogen plays in the body.

Oestrogens are a group of sex hormones that are mostly made by your ovaries. Estrogen plays a leading role in your health as it controls and influences the menstrual cycle, the reproductive system, the urinary tract, and your bones and heart. It also plays a part in making sure your pelvic muscles and bladder tissues are strong — and that’s just some of the areas it’s responsible for.

During perimenopause and menopause, your ovaries begin to produce less oestrogen. This can affect the pelvic floor muscles and the urethra sphincter (the short tube that passes urine from the bladder out of the body) to weaken (1,2).

The pelvic floor is made up of layers of tissue and muscles that act as a supportive hammock to the bladder. As the pelvic muscles weaken, it makes it harder to hold onto your wee and this is why you may leak when you cough, laugh, or sneeze.

The urethra keeps the bladder closed until it’s time to pee. As the drop in oestrogen production can also thin the lining of the urethra, it makes it harder for it to stay closed and this can lead to leakage.

Which type of incontinence does menopause cause?

There are various types of incontinence but there are three that are common during the menopause, these are(3,4):

  1. Stress incontinence. You may find that you leak wee when you laugh, cough, sneeze, exercise, or pick up a heavy object.
  2. Urge incontinence (also known as overactive bladder). This happens when the need to pee comes on quickly and you find yourself dashing to the bathroom.
  3. Overflow incontinence. You may feel as though your bladder isn’t emptying properly and this can lead to bladder leaks. You may find yourself pushing hard to begin to wee and find it hard to keep the stream of wee flowing.

Incontinence may not be the only issue you have during the menopause. You may also find that you wee more through the night or get urinary tract infections (UTI’s) more often. These changes can also happen due to the changes in your oestrogen levels.

Side note: It’s important to add that although urinary incontinence and bladder problems are common during the menopause, you don’t have to accept it as a stage of life. It’s possible to put a stop to bladder leaks and there are various treatment routes you can take. Let’s dive in and take a look at the options.

How to treat urinary incontinence brought on by menopause

Each woman’s experience of bladder leaks during the menopause is unique, which is why it’s great that there are a range of treatment options to help.

Pelvic floor exercises

Let’s start with pelvic floor exercises, also known as Kegel exercises. This is probably one of the most talked about solutions to bladder leaks. Put simply, these are exercises that you can do at any time and anywhere. The reason for doing them is to strengthen your pelvic floor muscles, this then gives you more control of your bladder.

How do you do them? You tighten your pelvic floor muscles, hold for three seconds, and then release. The exercises are then repeated three times a day, it’s best to aim for three sets of 10 to 15 repetitions a day(5). Want to know more? Take a look at our article on how to do pelvic floor exercises.

Manually performing Kegel exercises requires daily consistency and ensuring that you are performing them correctly, otherwise you can do more harm than good. For busy women, we recommend seeking non-invasive solutions such as INNOVO that do the pelvic floor exercises for you whilst you sit back and relax or get on with daily life.

Living a healthy lifestyle

If you are experiencing urinary incontinence during menopause, making changes to your lifestyle can help put an end to your bladder leaks.

A good place to start is to check you’re a healthy weight. If you’re overweight, this can place strain on the pelvic floor muscles which may weaken them, and you’ve guessed it, this can lead to bladder leaks. Maintaining a healthy weight can ease this pressure and stop leaks when you cough, laugh, or sneeze.

You may find that reducing or ditching the amount of caffeine, fizzy drinks, energy drinks, and alcohol you drink reduces or stops your bladder leaks. If you don’t want to give up caffeine then try reducing it to less than 100 mg a day, as this has been shown to reduce the number of leaks, frequency, and urgency of weeing(6).

Another area you may want to consider is to make sure you’re getting enough fibre in your diet. Increasing the amount of veggies and fruit you eat can stop or reduce constipation, which can help stop urinary problems.

How much fluids to drink daily

If you find yourself peeing more through the night, then reducing the amount you drink before bed can help. You may be thinking to yourself, ‘what if I just drink less throughout the day?’ Although this sounds helpful, it can actually lead to further problems, such as irritating your bladder. Wondering how much to drink? Try and aim for 1.5 litres (6-8 glasses) of water a day.

Sometimes making changes to your lifestyle isn’t enough and your doctor may suggest you try a medical option such as:

  • Certain medications known as antispasmodics can help put an end to bladder leaks as they block the signals that cause the muscles in your bladder to spasm and leak
  • A low dose of vaginal oestrogen cream, which you rub on the inside of your vagina or urethra, can help put an end to stress or urge incontinence. There are other options available too, such as pessaries, a vaginal ring, and vaginal tablets

    Invasive vs non-invasive treatments

    You might have heard of women putting devices or probes into their vaginas to help stop leaks. Examples include urethral inserts that are placed inside your urethra which acts as a plug to stop leaks or electrical devices that send out low electrical currents to stimulate your pelvic floor muscles. For most women, they can be very uncomfortable and can lead to infection if not used correctly.

    Other safer, more convenient and comfortable options include INNOVO. Our non-invasive pelvic floor trainer is a pair of shorts that women simply slip on for 30 minutes a day that performs your pelvic floor exercises for you. INNOVO has undergone significant clinical studies, including a study that found it to be clinically safer over probe-based treatments.

    Some women find that although they’ve made lifestyle changes, tried medications, and practised pelvic exercises for some time, their incontinence doesn’t get any better. If this is you then your doctor may suggest surgery to lift the bladder and/or support the urethra as a solution to your bladder leaks.

    Innovo helps you treat incontinence following menopause

    As you enter the menopause, oestrogen levels drop. The pelvic floor muscles may weaken, which can lead to bladder leaks. During the menopause, leaks when laughing, exercising, sneezing, or coughing are particularly common.

    As every woman’s experience of urinary incontinence is different, it’s great that there’s a range of treatment options available, from lifestyle changes to medication. We touched on pelvic floor exercises being one of the key treatments in reducing or stopping bladder leaks, which is great — but we know what you’re thinking, they’re time-consuming and tricky to know if you’re getting right.

    Cue INNOVO. INNOVO has been created to do your pelvic floor exercises for you. How? You simply wear the shorts, connect the controller, set the intensity that is right for you, and get comfortable for 30 minutes so INNOVO can work on strengthening your pelvic floor for you (180 squeezes to be exact). Find out how INNOVO works and how it can help put a stop to your leaks in as little as 12 weeks(7).

    Sources

    1. The North American Menopause Society. Urinary Incontinence. Accessed August 2021.
    2. Healthline. How Does Menopause Affect OAB? Updated August 2018.
    3. Cleveland Clinic. Menopause, Perimenopause and Postmenopause. Reviewed December 2019.
    4. Bladder & Bowel. Overflow Incontinence. Modified June 2021.
    5. Mayo Clinic. Kegel Exercises: A how-to guide for women. September 2020
    6. Bladder Matters. Diet and Lifestyle. Updated January 2020.
    7. R. Dmochowski – Novel external electrical muscle stimulation device for the treatment of female stress urinary incontinence: randomized controlled noninferiority trial versus intravaginal electrical stimulation. ICS Conference 2018
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