Incontinence Advice

Managing Incontinence During Menopause

The menopause is a natural phase in a woman's life, which can often bring unexpected challenges. One such challenge is bladder weakness or incontinence, an issue many may not talk about openly. While the connection between menopause and bladder control isn't always discussed openly, it's a reality for many women. In this article, we will give you all the information that you need to know about managing incontinence during menopause and offer tips on how to manage and navigate the condition.

woman managing menopause incontinence

Understanding Incontinence in Menopause


Incontinence is not just about the involuntary leakage of urine; it's about the loss of control and the accompanying emotional distress. The decline in oestrogen during menopause affects the urinary tract, leading to the thinning of the urethra lining, reduced bladder elasticity, and weakened pelvic muscles.

Menopausal Effects

While many consider menopause to be associated with hot flushes and mood swings, it also affects the urinary tract and bladder, and can easily be overlooked. Remarkably, up to 50% of post-menopausal women can face occasional urine leakage. Therefore, it is vital to understand the reasons behind this and look into potential treatments that can help the changes during menopause.

Why Menopause Can Lead to Incontinence and Bladder Challenges

We understand that menopause can cause a reduction of oestrogen production, a hormone vital for the health of the bladder and urinary tract. This decline can manifest as vaginal dryness, increased urinary frequency, urgency, and occasional leakage, all of which can lead to "genitourinary syndrome of menopause" (GSM). 

Notably, while 40-60% of postmenopausal women may encounter GSM, a limited number actively pursue treatment. Let's look at the various incontinence types linked to menopause and GSM.


Understanding Incontinence in Menopause


Approximately 30-40% of women will be affected by bladder weakness due to menopause, with the number increasing to 50% for postmenopausal women. Pregnancy in the past also plays a vital role too; women who have given birth tend to be more susceptible than those who haven't.

Factors such as weight, alcohol and caffeine intake, and specific medications can elevate the risk of urinary incontinence. Additionally, urinary tract infections (UTIs) may lead to temporary episodes of incontinence.

woman managing stress incontinence menopause

Types of Incontinence Linked to Menopause


In this section, we will look at the types of incontinence that are linked to menopause in women. Understanding the differences between these variations will help you to better understand how each type of incontinence works, and the symptoms that are underlined with them. 


Stress Incontinence

If you have stress incontinence, you may experience urine leakage when you cough, sneeze, laugh, jump, or lift certain objects.

Learn more about stress incontinence in women to develop a better understanding of this form of incontinence.

Urge Incontinence

Another common form of incontinence is known as urge incontinence and can occur when you have a frequent or urgent need to urinate. This can also be affected by waking up multiple times during the night; this is often referred to as nocturnal enuresis

Mixed Incontinence

As the name suggests, this is a combination of both stress and urge incontinence. Women experiencing mixed incontinence face challenges from both fronts, making it particularly distressing.

How to Manage Incontinence during Menopause


Whilst managing incontinence, menopause might bring other symptoms such as vaginal prolapse or anxiety. While there are temporary solutions, they might not be viable in the long run. It's best to consult your GP.

  • Plan Ahead: Before heading out, familiarise yourself with the locations of nearby public toilets. Always keep a change of product on hand for public toilets.
  • Opt for Absorbent Products: MoliCare® offers highly absorbent pads and underwear to manage leaks, especially during physical activities. Modern underwear designs combine style with functionality. We offer plenty of incontinence products for women and pull-up pants.  
  • Safeguard Your Bed: Consider purchasing bed mats, and either washable or disposable absorbent sheets online. Be sure to check out our page on incontinence bed protection to protect your bed from all forms of incontinence. 

Hormone Replacement Therapy (HRT) and Incontinence


Hormone Replacement Therapy (HRT) can replenish the loss of oestrogen levels during menopause, potentially alleviating incontinence symptoms. However, it's not a one-size-fits-all solution. The decision to use HRT should be based on each symptom, medical history, and potential risks. Some studies suggest that HRT might exacerbate incontinence in some women, so it's crucial to have an open discussion with your GP first before deciding.


Risk Factor Assessment

While menopause can lead to bladder issues, combining it with certain conditions can heighten the risk of urinary incontinence.

Alcohol & Caffeine Consumption: Drinks containing alcohol or caffeine can stimulate the bladder, leading to frequent urination. Limiting your intake of these liquids will decrease the risk of having urinary incontinence. 

Infections: Urinary tract or bladder infections might result in temporary incontinence. Once the infection is treated, symptoms often diminish or disappear.

Nerve Damage: Damage to nerves can disrupt communication between the bladder and brain, affecting the sensation of needing to urinate and impacting bladder control.

Specific Medications: Some drugs, including diuretics and steroids, might have incontinence as a side effect.

Constipation: Persistent constipation can influence bladder function and weaken pelvic muscles, complicating urine retention.

Excess Weight: Being overweight can elevate the risk due to added pressure on the bladder, potentially initiating or exacerbating incontinence.

How to Treat Bladder Weakness During Menopause

1. Pelvic Floor Exercises:
Daily pelvic floor exercises can enhance bladder control during menopause.


2. Bladder Training:
Schedule bathroom visits throughout the day. This helps in gradually increasing your bladder's capacity.


3. Lifestyle Adjustments:

  • Reduce caffeine and alcohol intake; they increase urination.
  • Ensure you drink the right amount of water.
  • Shedding extra weight can lessen the strain on your bladder and pelvic area.
  • Understand the importance of a healthy menopausal lifestyle for better bladder control by knowing about the best bladder friendly drinks
treatment options to manage incontinence during menopause

The Role of Weight in Incontinence


Weight plays a more significant role than most realise in managing incontinence during menopause. Excess weight, especially around the abdominal area, exerts additional pressure on the bladder and pelvic floor muscles. This added pressure can exacerbate incontinence symptoms. 

By adopting a balanced diet, engaging in regular physical activity, and losing those extra pounds, you can significantly reduce the risk of incontinence episodes.

Treatment Options for Urge and Stress Incontinence


Many women face the challenges of urgency and frequent urination, disrupting their daily routines. Whilst there are incontinence pads for women, there are also medicinal and surgical solutions available. 

Medication for Urge Incontinence:

For those troubled by constant urination urges, antimuscarinic drugs might be the answer. These bladder relaxants can offer relief, especially when combined with pelvic floor exercises and bladder training. Always discuss potential side effects with your doctor.

Surgical Procedures for Urge Incontinence:

If traditional treatments don't alleviate urge incontinence, surgical options might be considered:

  • Botulinum Toxin A Injections: Botox injections into the bladder walls can calm overactive muscles. Their effects can last months, with the option for further treatments if required.
  • Sacral Nerve Stimulation / Posterior Tibial Nerve Stimulation: This method uses electrical currents on bladder-controlling nerves to manage the bladder muscle. While effective, it's less common due to the success of non-surgical treatments.

Surgical Procedures for Stress Incontinence:

Stress incontinence, or urine leakage during physical activities, can often be managed by strengthening pelvic floor muscles. If symptoms persist, surgical interventions might be explored:

  • Colposuspension: This surgical procedure involves lifting the neck of the bladder and stitching it in place. By repositioning the bladder neck, it offers long-term relief from stress incontinence.
  • Sling Surgery: Here, a supportive sling, crafted from human or animal tissue or even synthetic materials, is placed around the bladder neck. This acts as a hammock, supporting the bladder and preventing unintentional leakage.
  • Urethral Bulking Agents: These agents, when injected, bulk up the urethra walls. By enhancing its size, they ensure the urethra closes more effectively, reducing episodes of leakage.

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Multiple Approaches for Managing Incontinence Throughout Menopause:


In summary, there are many ways to manage incontinence during menopause. It requires a multifaceted approach, since women can benefit differently from each option laid out throughout this article, including bladder control training and medication. If symptoms persist, surgical options, ranging from Botox injections to sling surgery, offer viable solutions. It's crucial to consult with your GP to determine the most suitable treatment. 


What causes incontinence during menopause?

The decrease in oestrogen during menopause can lead to the thinning of the urethra lining, weakening of the pelvic muscles, and reduced bladder elasticity, all of which can contribute to incontinence.

Are there exercises that can help with incontinence?

Answer: Yes, pelvic floor exercises, often referred to as Kegel exercises, can strengthen the muscles that support the bladder and improve bladder control.

Can hormone replacement therapy (HRT) help with incontinence during menopause?

Some women find relief from incontinence symptoms with HRT, but it's essential to discuss potential risks and benefits with a doctor.

How does weight affect incontinence during menopause?

Excess weight can put additional pressure on the bladder and pelvic muscles, exacerbating incontinence symptoms. Maintaining a healthy weight can help reduce this risk.

Can lifestyle changes help manage incontinence?

Absolutely. Reducing caffeine and alcohol intake, drinking an appropriate amount of water, and avoiding bladder irritants can help manage symptoms.