Menopause can indeed cause incontinence in some women. This occurs because declining estrogen levels often lead to changes in the urinary tract that can provoke urinary urgency and leakage. Some key points about menopause and incontinence:
- The most common type of incontinence associated with menopause is urge incontinence. This involves a sudden, intense urge to urinate followed by an involuntary loss of urine.
- Estrogen helps maintain the lining of the urethra and bladder. With less estrogen, these tissues can become drier, thinner, and less elastic. This shrinkage and loss of flexibility can irritate nerves and make it harder for the bladder to store urine.
- Incontinence isn't inevitable with menopause. While up to 23% of postmenopausal women have incontinence, many women transition through menopause without bladder issues. Other factors like childbirth, genetics, smoking, obesity, and caffeine intake also play a role.
What happens during menopause that provokes incontinence?
- Declining estrogen. This leads to changes in tissues lining the urethra and bladder.
- Decreased blood flow. Lower estrogen reduces blood flow to the pelvis and urethra, decreasing muscle tone.
- Bladder irritation. Thinner, drier tissues can provoke bladder spasms and urgency.
- Decreased urethral closure pressure. This makes leakage more likely when intra-abdominal pressure increases, like with exercise, laughing, or sneezing.
Menopause-related incontinence usually improves with treatment. Options can include:
- Lifestyle changes:
- Losing extra weight
- Avoiding bladder irritants like caffeine
- Doing Kegel exercises to strengthen pelvic floor muscles
- Changing diet to reduce UTIs
- Vaginal estrogen therapy:
- Helps improve elasticity and moisture in urogenital tissues
- Often effective to improve incontinence
- Available as creams, tablets, or rings
- Local effect, so less systemic absorption
- Prescription medications:
- Anticholinergics treat urge incontinence by relaxing bladder muscles
- Mirabegron also relaxes the bladder to increase storage capacity
- Duloxetine can tighten sphincter muscles around the urethra
- Medical procedures:
- Bulking agents injected into the urethra to 'bulk up' tissue
- Sling surgeries to support urethra and prevent leakage
- Neuromodulation therapies to control bladder contraction signals
The specialists at
Renewed Balance Clinic have over 15 years of experience successfully treating incontinence related to menopause and hormonal changes in women. We take a comprehensive, integrative approach focused on restoring optimal hormone balance and pelvic floor strength through customized bioidentical hormone therapies, targeted lifestyle plans, cutting-edge therapies like platelet-rich plasma, and advanced neuromodulation techniques. Contact us for a consultation if you’re struggling with menopause-related incontinence - we can help you reclaim control and confidence.
