Urinary Incontinence and Menopause

Urinary incontinence affects millions of women at some point in their lives. What is it? How does it impact midlife? What can you do about it? Read on to learn about one of the most obnoxious - but common - side effects of getting older as a woman.  

What is urinary incontinence?

Urinary incontinence is the involuntary leakage of urine. 

It affects nearly twice as many women as it does men. Studies show that urinary incontinence affects around 20-30 percent of young women, 30-40 percent in middle-aged women, and up to 50 percent of older women. 

As estrogen levels decline during menopause, the lining of your urethra - the tube that passes from your bladder out of your body - gets thinner. On top of this, your pelvic muscles tend to weaken during midlife, called vulvovaginal atrophy. Both of these things together can cause urinary incontinence. 

Additionally, research shows that factors like anxiety, weight gain, and diabetes can increase your risk of developing urinary incontinence.

There are three main types of urinary incontinence that affect women:

  • Stress incontinence, which is caused by things like sneezing, coughing, laughing, intercourse, or even lifting heavy objects.

  • Urge incontinence, which is caused by overactive or irritated bladder muscles. It’s also called overactive bladder, and most commonly presents as the frequent need to pee.

  • Overflow incontinence, which is caused by your bladder not emptying fully. Overflow can present as urine dripping somewhat continuously, feeling like you have to pee all night, or hesitancy when trying to urinate.

The result of urinary incontinence could be a slight leakage or a complete loss of bladder control. Either way, it’s not an enjoyable experience and causes a lot of unnecessary distress for women.

Risk factors for urinary incontinence

It’s helpful to know what things can increase your risk for urinary incontinence so you can make lifestyle changes, when possible. It’s also a good idea to have a conversation with your doctor about risk factors that lifestyle interventions can’t address. 

  • Drinking beverages that contain alcohol or caffeine, which can fill your bladder more quickly

  • Having urinary tract infections, which can increase the feeling of urgency to urinate

  • Having nerve damage that can interrupt communication between your brain and bladder, making it difficult for your body to know when it’s time to empty your bladder

  • Using medications like steroids or diuretics, which can cause urinary incontinence as a side effect in some people

  • Being overweight or obese, as extra weight can put pressure on your bladder

  • Constipation, either acute or long-term, can also put pressure on your bladder

  • If you’re experiencing any degree or type of urinary incontinence, know that you’re not alone and that there are many things you can do to help alleviate this condition. Talk to your doctor to explore all of your options. Non-prescription remedies may take time. Don’t give up 

How does urinary incontinence impact midlife?

Having urine leakage is associated with a decreased quality of life, which is not very surprising. Nobody wants to have to deal with unpredictable and unavoidable urine leakage, especially when out and about or in social situations. 

Research shows that women who have vulvovaginal atrophy symptoms (also known as genitourinary symptoms of menopause or GSM) report a much worse quality of life than women who have only mild menopausal or urinary incontinence symptoms. Reduced quality of life among women with urinary incontinence is especially reported among women who have other disruptive menopausal symptoms, like vaginal dryness, night sweats, and hot flashes. 

Does urinary incontinence worsen over the menopause transition?

Not necessarily, but it might for some women. A 2011 study found that menopausal stage transition – going from early perimenopause to late perimenopause - was associated with women seeing monthly or more frequent incontinence. In contrast, women in postmenopause were approximately half as likely to develop this degree of incontinence. Menopausal stage was not found to be associated with more frequent incontinence. Rather, worsening anxiety symptoms, a high baseline BMI, weight gain and recently diagnosed diabetes were associated with developing more frequent incontinence. The authors suggested that healthy life changes could be an essential intervention in this condition. 

5 solutions for urinary incontinence

Your risk for urinary incontinence increases as you age, especially if you’ve had children. However, this doesn’t mean it’s an inevitable part of the aging or menopausal process. It also doesn’t mean you have to accept it as something you have to live with.  

Here are five options to alleviate urinary incontinence: 

  1. Strengthen your pelvic floor muscles by practicing exercises like Kegels, certain yoga poses, bridges, and squats. Check out our guide to the best strengthening exercises you can do at home, work, and during your workout.

  2. Retrain your bladder to hold urine regularly by getting into a routine of bladder emptying. In other words, try and urinate around the same times every day. 

  3. Consider medications designed to help, such as anticholinergics, which calm an overactive bladder. Drugs like Mirabegron (Myrbetriq) may also be used to help increase the amount of urine that your bladder can hold without leakage.

  4. Try devices made specifically to help with urinary incontinence. One of the most common is the pessary, a ring used to reduce urine leakage by repositioning your urethra.

  5. Discuss potential surgical options with your healthcare provider if nothing else seems to work. Surgery is typically a last resort option.

In recent years, new holistic tech-forward products have come on the market to help women deal with urinary incontinence. They range from pelvic floor strengthening apps to kegel devices to pee proof undies.

If you’re experiencing any degree or type of urinary incontinence, know that you’re not alone and that there are many things you can do to help alleviate this condition. Talk to your doctor to explore all of your options. Non-prescription remedies may take time. Don’t give up!

For more women’s health and menopause tips, head over to Lisa Health

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