For many women, menopause isn’t just hot flushes—it’s bladder changes too. Menopause and incontinence often go hand in hand, but it’s a topic that doesn’t get talked about enough.
Menopause is an extremely challenging time for women, and how it affects your bladder health can also impact your mentality. In this article, we’ll explore how menopause affects bladder control, what types of incontinence are most common, and what you can do to manage symptoms.
Key Points:
- Menopause can trigger bladder issues like urge or stress incontinence
- Weakened pelvic floor muscles and low oestrogen levels are common causes
- Lifestyle habits like staying hydrated and cutting back on caffeine can help
- Pelvic floor exercises (Kegels) are a simple way to regain control
- Treatments range from pads and medication to surgery for severe cases
Types of Urinary Incontinence
Not all bladder leaks are the same. There are several different types of urinary incontinence, and each one can affect women during or after menopause in different ways. Understanding the differences can help you spot the signs and seek the right support.
- Urge incontinence: A sudden and strong need to urinate, followed by leakage. This urge can come on quickly and may result in not reaching the toilet in time.
- Stress incontinence: Leaking when pressure is put on the bladder—for example, when coughing, sneezing, laughing, or lifting. This is especially common during and after menopause.
- Mixed incontinence: Some women experience both urge and stress incontinence at the same time, which is known as mixed incontinence.
- Overflow incontinence: When the bladder doesn’t empty fully, small amounts of urine may leak regularly. You might not even feel the urge to go.
- Total incontinence: In more severe cases, the bladder loses all control, leading to constant or unpredictable leaking.
When Does Menopause Start?
Menopause is a natural part of getting older. It usually begins between the ages of 45 and 55, with the average age in the UK being 51. It marks the end of menstrual cycles and happens when your ovaries stop releasing eggs. On average, menopause can begin if you haven’t had a period for 12 months in a row (and it’s not caused by pregnancy or illness).
Hormonal changes during this time can affect much more than just your period. Physical symptoms can include:
- Hot flushes
- Heart palpitations
- Difficulty sleeping
- Headaches
- Weight gain
- Aching muscles or joints
- Vaginal dryness and discomfort
- Lower sex drive
- Frequent urinary tract infections
- Less control over the bladder or bowels
Menopause and Incontinence
The link between menopause and incontinence is more common than many realise. There are plenty of organisations that support women going through this phase, such as menopause matters.
Falling oestrogen levels can weaken the muscles around the bladder and urethra, making leaks more likely.
Here’s how menopause incontinence often develops:
- Thinner urethral lining: Reduced oestrogen weakens the tissues that help control urine flow.
- Weaker pelvic floor muscles: These muscles support your bladder, and without strength, control is reduced.
- Bladder changes: The bladder can lose elasticity, causing more frequent urges to go.
- Weight gain: Added pressure on the bladder and pelvic floor can worsen leaks.
- Vaginal dryness: Increases the risk of UTIs, which can worsen incontinence symptoms.
If menopause incontinence is left untreated, it can affect physical and mental health—leading to issues like repeat infections, low confidence, and even depression.
Managing Menopause-Related Incontinence
Small day-to-day changes can make a noticeable difference before you ever reach the doctor’s office. Use the ideas below as a toolkit—mix and match until you find what steadies your bladder.
Strengthen Your Pelvic Floor
A strong pelvic floor is the frontline defence against menopause incontinence. Kegel exercises for women are simple, discreet and can be done almost anywhere:
- Sit tall, breathe out, then squeeze the muscles you would use to stop urine. Hold for a count of five, release for five. Repeat ten times.
- Lie on your back with knees bent. Tighten the same muscles, hold three seconds, relax for three seconds. Build up to ten repetitions, three sets a day.
- Aim to practise most days. You should notice fewer leaks within eight to twelve weeks.
Tweak Drinks and Diet
Cut back on caffeine and alcohol. Both irritate the bladder and boost trips to the loo. Swap coffee for decaf, black tea for herbal blends, and track the difference for two weeks. Read more about dietary help for incontinence in these guides:
Stay hydrated
Drinking too little concentrates urine, which further irritates the bladder lining. Sip water steadily instead of downing large glasses at once.
Watch your weight
Extra kilos add pressure to the pelvic floor. A mix of brisk walking, strength moves and balanced meals can lighten the load and reduce leaks.
Need discreet protection while you build new habits? Shop for washable incontinence pants for women
Bladder Training
Set a regular schedule—say every two hours—to visit the toilet, even if you don’t feel an urge. Gradually stretch the interval by 15 minutes each week. Over time your bladder can relearn to hold more without unexpected signals, easing both urgency and frequency.
When Lifestyle Measures Aren’t Enough
If self-help steps haven’t slowed leaks after three months, talk with your healthcare professional. Options include:
| Option | How It Helps | Typical Follow-Up |
| Medication (antimuscarinics or mirabegron) | Calms overactive bladder muscles | Review after 4–6 weeks |
| Vaginal oestrogen creams | Restores tissue strength around urethra | Ongoing GP check-ups |
| Nerve stimulation (PTNS/TENS) | Sends gentle pulses to reset bladder signals | Weekly sessions for several weeks |
In conclusion, menopause and incontinence often go hand in hand, but there are ways to take back control. From recognising the different types of incontinence to making small lifestyle changes like doing pelvic floor exercises or adjusting your diet, there are steps you can take to manage symptoms. Whether you try self-care strategies or seek medical advice, support is available. Don’t ignore the signs—understanding your bladder health is the first step towards feeling more confident each day.
FAQs
Does incontinence always go away after menopause?
Not always. For some women, bladder issues improve after hormone levels stabilise, but others may find symptoms continue without treatment. Pelvic floor exercises, bladder training, and lifestyle changes can help manage or reduce symptoms over time.
Can exercise make menopause incontinence worse?
Certain high-impact exercises like running, jumping, or lifting heavy weights can put extra pressure on the pelvic floor, potentially worsening leaks. Low-impact activities such as walking, swimming, Pilates, or yoga are often better choices while strengthening the pelvic area.
Sources
Menopause Matters. (2002) Homepage. [online]Available at: https://www.menopausematters.co.uk/ [accessed 26/06/2025]
About the author
Julie Boultwood is the strategic eCommerce manager for HARTMANN Direct. With over 25 years of experience in marketing, she has developed expertise in several industries including healthcare, agriculture, and travel. View her social media.
