Menopause and Incontinence
What is incontinence in menopause?
Menopausal incontinence is when women occasionally lose control of their bladder, resulting in urinary leakage.
What causes incontinence during and after menopause?
- There are three different types of incontinence during menopause that are differentiated by their causes.
- Stress incontinence. This is caused by physical stress or exertion that puts pressure on the bladder, causing urine to leak. Coughing, laughing, sneezing, exercise, and heavy lifting are some activities that can lead to this type of incontinence.
- Urge incontinence. Also known as overactive bladder, the symptoms are a constant or sudden need to urinate.
- Overflow incontinence. This occurs when the bladder doesn’t completely empty during urination.
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What is happening inside your body?
During menopause, estrogen levels decline, affecting the muscles and tissues involved during urination. Lower estrogen levels thin the lining of the urethra, making it more prone to leakage. It also causes a weakening of the pelvic floor muscles, which line the bottom of the pelvis, surround the urethra, and hold up the bladder, bowel, and uterus.
Other menopause-related changes like weight gain and chronic constipation can also apply pressure to the bladder causing it to contract, fill, or empty improperly.
What are some medical-provider-prescribed treatments for incontinence in menopause?
- Anticholinergic drugs: This drug counteracts the effects of acetylcholine, a chemical messenger in the body involved in abnormal bladder contraction, helping incontinence caused by an overactive bladder.
- Topical estrogen: This treatment provides a low dose of estrogen to the vagina and urinary tract area—helping counteract changes like weakening of the pelvic muscles and thinning of the urethral lining.
- Pessaries: This soft device is inserted into the vagina to compress the urethra and support the bladder, helping prevent leakage. For people with severe stress incontinence, pessaries can be a helpful alternative to surgery.
- Surgery: When other treatments do not achieve the desired results, your doctor may recommend surgery that adds support to the bladder and urethra.
What should you do next?
Let’s get you prepared to be paired with your provider!
Select and submit all of the symptoms you are currently experiencing so your doctor can assess and provide a tailored treatment plan for you.
of Members report symptom improvement within 3 months.
care at your fingertips.
of Members report symptom improvement within 3 months.
care at your fingertips.
References
- Research published in the journal Menopause in 2021 found that postmenopausal women between age 45 and 54 are more likely to have overactive bladder syndrome (urge incontinence) than women of other age groups.
- A review published by Cochrane Library in 2012 found that locally applied estrogen (such as vaginal creams or tablets) showed promise in helping alleviate incontinence.
- A small study published in Maturitas in 2019 suggested that pelvic floor muscle training, better known as Kegel exercises, is an effective treatment for urinary incontinence.
