Understanding the Relationship Between Menopause and Incontinence
Going on multiple bathroom trips a night? Check. Experiencing unexpected leaks when you laugh at a funny joke or have a strong sneeze? Double check. Urinary incontinence is extremely common for women going through major hormonal changes, such as pregnancy and postpartum, and it’s especially common for postmenopausal women. The question remains: Does menopause directly cause incontinence? If so, how do you prevent or stop leaks from occurring? Here, we’ll explain everything you need to know about the various types of urinary incontinence and how they relate to menopause.
How Menopause and Incontinence Are Related
Older adults who experience leakage may feel embarrassed, discouraged, or alone, but rest assured that urinary incontinence (the unintentional loss of urine) is extremely common. This is especially true as women age due to hormonal and anatomical changes. At the start of menopause, estrogen levels significantly decline, causing thinning of the urethral lining and loss of elasticity in vaginal tissue. In addition, pelvic muscles around the bladder begin to weaken, which is known as “pelvic relaxation.” This, too, leads to an increased risk of urinary leakage. UI (urinary incontinence) affects more than 50% of postmenopausal women, and for the overall population, it affects women twice as much as men.
Causation vs. Correlation
Does menopause directly cause incontinence? The answer is no — however, menopause can be the very thing that triggers incontinence. In an article by Balance by Newsom Health, Dr. Clair Crockett notes that many women who experience continence issues post-pregnancy find these problems escalate as their estrogen levels diminish, typically in their 40s.
There are certain factors that may raise the likelihood of experiencing incontinence later in life, including:
- Pregnancy and vaginal birth
- Having a hysterectomy
- Aging muscles
- Dropped estrogen levels
- Cancer treatments in the pelvic area
- Prolapse: A common condition where some of the pelvic tissues slip down and bulge from the vagina
- A family history of incontinence
- Obesity
- Constipation
- Smoking
- Nerve damage: Common with those who have diabetes, nerve damage can send the wrong signals to the bladder
- Certain medications: Medicines like diuretics (“water pills”) can contribute to incontinence
The Prevalence of Incontinence in Postmenopausal Women
There is a high correlation between menopause and incontinence. More than half of postmenopausal women experience incontinence, as mentioned above, and up to 75% of women over the age of 65 report urine leakage. However, most women put off seeking help for far too long. According to the National Association for Incontinence, women wait an average of 6.5 years after their first symptoms to get diagnosed by a professional. By taking out the stigma and seeking support early on, postmenopausal women can reduce urine leaks, improve their quality of life, and curb the symptoms of menopause altogether.
Types of Incontinence Associated with Menopause
Incontinence is a field of its own, and there are five types of incontinence that impact women’s health. The three main types of incontinence associated with menopause include:
- Stress urinary incontinence (SUI), aka “the leaky valve,” is the most common type of UI and represents 50-88% of incontinence cases. SUI is when you leak a small amount of urine when you sneeze, cough, jump, laugh, or exercise. The urethra muscles are weakened, causing urine to slip out much easier.
- Urge incontinence (UUI), aka “overactive bladder,” is a type of incontinence that affects about 17% of women and occurs when you suddenly (and urgently) need to use the toilet – and it happens so quickly that accidents often happen. Women may feel that they need to urinate often or get up several times a night to go to the bathroom.
- Overflow incontinence: This type of incontinence occurs when the bladder does not empty sufficiently, and when the bladder is at capacity and cannot hold more urine, it forces urine to leak out unexpectedly. Quite the opposite of an overactive bladder, women feel less of a need to urinate and have a slow or delayed urinary stream. Because of this, UTIs (urinary tract infections) are more common.
Symptoms of Incontinence During Menopause
There are many signs and symptoms of incontinence during menopause, and there are also different types of symptoms depending on what type of incontinence you experience:
- For stress incontinence driven by weak pelvic floor muscles, symptoms include leakage caused by sneezing, coughing, laughing, jumping up and down, and exercising. Sudden movement, combined with a thin urethra lining and pelvic floor muscles, can cause unexpected leakage of urine.
- For urge incontinence or an overactive bladder, individuals may experience frequent and sudden urges to urinate, leading to accidents and leaks.
- For overflow incontinence, individuals may feel a diminished need to urinate at all, have a slow urinary stream, or experience leaks if the bladder is too full.
Ways to Manage Menopause-Related Incontinence
Urinary incontinence post-menopause can feel embarrassing, isolating, and frustrating – but it doesn’t have to be. Here are some therapies and management strategies to explore when experiencing urinary incontinence:
- Pelvic floor muscle therapy and rehabilitation: Strengthen your pelvic muscles to significantly improve incontinence symptoms. Find a certified pelvic floor physical therapist who can provide comprehensive pelvic floor exercises such as kegel exercises to bring strength and tone back to the area.
- See a doctor (specifically a gynecologist or urologist): Work with a healthcare professional to help identify your incontinence type and implement the best treatment. This may include prescription drugs, female pelvic medicine, or even reconstructive surgical treatments known as urogynecology.
- Bladder training (a behavioral method): Reverse bladder weakness by training your body. Bladder training is a holistic method that combines a wide variety of treatments such as biofeedback, electrical stimulation, behavioral modification training, and massage to get your pelvic muscles back to working properly.
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Products that give you back your confidence: While seeking help for the long-term, it helps to use products that keep you confident and worry-free in the short term. Here are some of our top picks:
- Prevail ® Underwear for Women with Maximum Absorbency - For day and night use, this product is meant to be worn as daily underwear, so you never have to think about accidents again. It’s stretchable, breathable, and has moisture-wicking technology to keep you dry 24/7.
- Dry Direct Overnight Bladder Control Pads - Our highest-rated pad that’s worn with underwear, Dry Direct provides ample coverage for overnight use, offering twice the absorbency of regular pads.
- Poise Pads Maximum Absorbency - Made with BodyFit technology that contours to your shape, Poise pads are soft and comfortable with Absorb-Loc and Comfort-Dry to seal in moisture and provide a dry feeling during use.
- Dry Direct Ultimate Underwear- Our best incontinence underwear is the culmination of years of research and testing. It has 3x the absorbency of anything found in stores, resulting in fewer changes per day and fewer trips to the bathroom