Why Perienopausal Incontinence Happens (And What To Do About It)

Among all the awkward and taboo symptoms that come about when you begin to experience menopause, urinary incontinence is perhaps one of the hardest to talk about. 

Many, many women going through perimenopause and menopause find that they have less control over their bladder than they used to, leading to involuntary urine passing. While it can be a difficult and embarrassing subject to talk about, it’s important to know that you’re not alone, and that there are many ways that you can minimize the frequency of unwanted bladder leaks. Addressing it is the first step to finding the right solutions for you. 

So let’s have a frank discussion about menopause, incontinence, and how you can stop those involuntary leaks and continue living life to the fullest no matter what stage of life you are in. 

Menopause And Incontinence

Perimenopausal incontinence has several different causes, but they all stem from the changing hormone levels that happen as you embark on your menopause journey. 

As you approach menopause, your body starts making less and less estrogen. This hormone is primarily known for its effects on managing and controlling your reproductive system, which includes the health and structure of your vaginal tissues. Altogether, the effects that menopause has on the health and strength of your vaginal and bladder are called the genitourinary syndrome of menopause

As estrogen decreases, many women find that their vaginal tissues shrink and become less elastic. This can present itself in a couple of different ways, including vaginal irritation and dryness. The same applies to your urethra, or the tube that you urinate out of, which goes on to affect your ability to control your bladder. 

In addition, the decrease in estrogen can also cause a loss of muscle mass, including the muscles in your pelvic floor. Your pelvic floor supports your bladder, so if it starts to weaken, it makes it much harder to hold in your urine. 

The two most common types of perimenopausal incontinence are:

  • Stress incontinence: This type of incontinence is caused by those weakened pelvic floor muscles. Women who experience stress incontinence might find that they accidentally leak from forceful movements like coughing, laughing, or from lifting heavy objects. 

  • Urge incontinence: Urge incontinence happens when your bladder is “overactive” or irritated, and presents itself as frequent and/or sudden urges to use the bathroom.

  • Because the decrease in estrogen can also make it harder to fully empty your bladder, your risk for having a urinary tract infection (UTI) also increases, exacerbating any urination problems. 

    Problems with incontinence may begin during perimenopause, or the period of time where your sex hormones are fluctuating and decreasing to signal the end of your natural reproductive cycle. Post-menopause, incontinence issues can continue or worsen. 

    Natural Solutions for Perimenopausal Incontinence

    You don’t have to accept incontinence as an inevitable part of getting older - in fact, there are plenty of things that you can do to minimize the instances of involuntary bladder leaks. 

    Natural solutions for perimenopausal incontinence include: 

    • Minimizing your diuretic intake. Diuretics are any substances that trigger your body to release more liquid. Caffeine and alcohol are particularly popular diuretics, so it might be time to cut back if you find yourself having to use the bathroom more often. 
    • Balancing your hormones. Menopause symptoms like incontinence are largely a product of hormonal changes, and finding ways to balance your hormones can help. Consider using natural supplements and herbs like red clover and black cohosh that contain phytoestrogen, a plant compound that closely mimics the structure of human estrogen. Many women find that using these supplements helps reduce the symptoms that come from reduced estrogen levels during menopause. 
    • Maintaining a healthy weight. Women who are overweight or obese are more likely to develop incontinence issues than women who are at a healthy weight since the added fat tissue can increase the pressure on your bladder. It doesn’t have to be too drastic;  losing even 5-10% of your bodyweight if you are overweight can help minimize involuntary bladder leaks. 
    • Get into a regular bathroom schedule. Regularly emptying your bladder can help both with minimizing accidental leaks and strengthening your pelvic floor muscles. 

    The Power Of Kegels 

    One of the best ways to fight off the urogenital symptoms of menopause is to regularly practice Kegels. These exercises target your pelvic floor muscles, strengthening them and reducing the risk of stress incontinence. 

    In order to do Kegels correctly, identify the right muscles by going to the bathroom and stopping your flow of urine midstream. Those muscles that you engage are going to be your pelvic floor muscles, responsible for controlling your bladder. 

    When you’ve identified the right muscles to work, you can leave the restroom then go on to practice squeezing those muscles and holding them for a couple of seconds. Then, relax and repeat the movement 10-15 times. Practice this exercise regularly, at least three sets a day for the best results. Luckily, Kegels are subtle enough that you can practice them almost anywhere or anytime. 

    As you do your Kegels, make sure that you are isolating the correct muscles for the best results and not engaging your butt or core muscles. 

    Final Thoughts On Perimenopausal Incontinence

    Going through perimenopause can make you feel like you are losing control of your body, especially when it comes to urinary incontinence. Tackling this and other symptoms of menopause with the right balance of physical activity, diet, supplements, and lifestyle changes can go a long way in reducing the embarrassing symptoms and helping you gain control of your body again.