How Menopause Affects Bladder Control

As our oestrogen levels drop, the muscles and tissues that support the bladder and urethra may begin to weaken over time. Importantly, this can have a major effect on the pelvic floor and the muscles that hold everything in place.

This can lead to:

• Weaker pelvic floor muscles: making it harder to hold leaks

• Thinner, less elastic tissues: which offer less support to the bladder

With less support, it becomes harder to prevent leaks, especially during everyday movements like coughing, bending, or lifting.

Menopause can also make the bladder itself more sensitive. You might notice:

• A stronger, more sudden urge to go

• Less warning time before needing the toilet

• Going more often than you used to

Whilst frustrating this is actually quite common. This is because the bladder lining becomes thinner and more easily irritated, which can make it feel more “active” than before.

For some women, these changes are gradual. However, for others, things may feel like they are changing rapidly. 

Although menopause is our focus here, there are other factors that can make these symptoms worsen.

Hormone changes brought on by menopause are a big part of the picture, but they’re not the only factor. Here are some other factors that can also affect bladder control:

• Natural changes as a part of ageing

• Extra weight, which can put extra pressure on the bladder

• A history of pregnancy or childbirth

• Everyday habits like caffeine intake or fluid balance

• History of smoking 

Some of the above when combined with menopause can quickly lead to changes in bladder control or even incontinence. Ultimately though, everyone’s experience is different, which is why menopause bladder control can feel unpredictable at times.

Although these changes can be scary and incredibly frustrating you’re certainly not alone. Whilst changes in bladder control can become more common during menopause or as we age, it is always advised that you contact your GP at the first sign of changes. 

A medical professional can help put your mind at ease that changes are normal, or identify anything that needs investigating further. 

Bladder changes affect people in different ways and the same can be said for menopause incontinence. Although the way they show up can vary from person to person, understanding the different types of incontinence can make it easier to recognise what you’re experiencing and how to manage it.

Stress incontinence is one of the most common ways bladder changes can manifest during menopause.

Despite the name, it actually has nothing to do with mental stress or anxiety, and instead refers to leaks when pressure is placed on the bladder day-to-day. The most common triggers for stress incontinence leaks are:

• Laughing

• Coughing or sneezing 

• Exercising or lifting something heavy

This happens because the muscles that make up your pelvic floor muscles can become weaker during menopause, meaning they’re not always able to hold everything in place during moments where stress is placed on the bladder, leading to small leaks.

For more information on stress incontinence, how to manage it and what causes it, take a look at our in-depth guide to stress incontinence here.

Urge incontinence, sometimes referred to as an overactive bladder, is slightly different. Here, it’s less about predictable stress events on the bladder and more about misfiring signals in the bladder.

You might notice:

• A strong, immediate need to go

• Difficulty holding on long enough to reach the toilet

• More frequent trips throughout the day or night

Your bladder control and menopause are very tightly linked, with the latter sometimes causing the bladder to become more sensitive and reactive. 

In a normal bladder, the muscles are relaxed as the bladder fills up over time. When the bladder is about halfway full, many then develop the urge to urinate. Meanwhile, in an overactive bladder, the bladder muscles seem to give the message to the brain that the bladder is more full than it actually is. 

For more information on urge incontinence, we also have an in-depth guide on urge incontinence here.

As we mentioned earlier, incontinence affects everyone in slightly different ways. This means that many women don’t experience just one type of incontinence at a time. 

Mixed incontinence is the term used to refer to someone experiencing two or more types of incontinence frequently. This usually is a combination of both stress and urge incontinence. 

For example, you might have small leaks when you cough, but also experience sudden urgency at other times. This combination is very common during menopause and requires you to manage both symptoms independently from one another.

We have a whole breakdown on mixed incontinence which you can read here. We also have a guide to the four main types of incontinence if you are experiencing something we haven’t mentioned above.

We would be remiss to only address the physical changes behind menopause and bladder control. Alongside the physical symptoms of our bodies changing, there can also be a profound mental affect and how it affects someone’s day-to-day is just as important.

There are many ways in which changes to our bladder habits can have an impact everyday. 

During perimenopause or menopause you might find yourself:

• Thinking ahead about where the nearest toilet is

• Avoiding long walks, exercise classes, or lengthy travelling

• Waking up more often during the night to use the toilet

• Carrying extra protection, just in case

Even small changes can have a knock-on effect. From having less confidence when you’re out and about, hesitation before laughing freely or being active, to quietly adjusting your routine without really talking about why.

Unfortunately, this is often the part that goes unspoken. Bladder control and menopause isn’t just a physical shift, it can affect how you feel in your own body too.

It’s important to remember that these experiences are incredibly common, and they don’t have to limit what you do. With the right understanding and support, millions of women all over the world have found ways to manage symptoms in a way that means they’re controlling leaks, rather than the leaks controlling them.

Let’s take a look at some of the ways you can manage leaks and regain control.

If you’re noticing changes in your bladder control during menopause, there are many practical steps you can take to regain control. 

Even small adjustments like some of the ones below can make a real difference over time. Just like symptoms though, no two experiences are the same. What works for you, might not work for a sister or friend. This could mean trying slightly different products, or experimenting with changes to everyday habits at a pace that suits your lifestyle.

Speaking to a GP or continence specialist is always advised if you find that you’re experiencing changes in your body or bladder control. 

Although these changes may be routine as part of menopause, a medical professional can put your mind at ease and also identify anything else underlying which might be causing or worsening your symptoms. 

Speaking to a GP or medical professional means they can:

• Assess your symptoms

• Recommend tailored treatments or exercises

• Discuss options such as pelvic health physiotherapy or hormone support

By now, you’ve probably already heard of or even tried pelvic floor exercises. They have become a key part to many peoples lives, men and women alike. Because of the muscles they focus on training, they remain one of the most effective ways to improve menopause incontinence symptoms over time.

The muscles these exercises target are the ones that support your bladder, and strengthening them can help reduce leaks and improve control. The key here though is consistency. Think of it like any exercise, it can take time to see the results.

Even a few minutes a day can lead to noticeable improvements over time. If you’re unsure where to start, your GP or a pelvic health specialist can guide you and make sure you’re doing the exercises correctly.

We have a YouTube video on pelvic floor exercises which can help you get started below:

Whilst these might seem small in isolation, combining a number of these changes can have a noticeable effect on your daily symptoms with menopause incontinence. Some simple changes to your daily routine include:

• Reducing your caffeine and alcohol intake, which can irritate the bladder

• Staying hydrated over the course of the day, but avoiding large amounts of fluid in one go

• Trying to attain or maintain a healthy weight to reduce pressure on the bladder

• Managing other health issues, such as constipation, which can worsen leaks

Not to be confused with the above, bladder training involves gradually increasing the time between your toilet visits. This method is used frequently after people have gone through surgery, but it also applies here too. 

By increasing the time between your toilet visits over time, you can help your bladder hold urine more comfortably and reduce the frequency and severity of sudden urges.

Like pelvic floor exercises it is a process that can take time, but with consistency, it can help you feel less controlled by sudden urges.

Alongside lifestyle changes, you’ll likely need to find products that can help support you day-to-day in stopping leaks from ruling your routine. Most women find that using discreet protection, such as liners or pads, helps them carry on with their day without second-guessing every movement.

Depending on your needs, this might include:

• Light liners for occasional leaks

• Shaped pads for more reliable, day-to-day protection

• Protective waterproof underwear that feels close to regular underwear

• Supplements that help strengthen the pelvic floor

The right products can provide you with an extra layer of reassurance while you’re working on improving symptoms in the long-term. Finding the incontinence products that are right for you is a simple way to feel more comfortable, whether you’re at home, at work, or out and about.

We have a whole guide on each type of incontinence products for women, which might help you get started: Our Top Recommendations For Women's Incontinence Pants. 

HRT is a common treatment for menopausal symptoms, including incontinence. HRT works by restoring your body's oestrogen levels. The increase in oestrogen can improve bladder and urethral tissues. 

There has been a lot of controversy around HRT recently due to unsubstantiated reports that it can increase the risks of breast cancer. Currently, research hasn’t been able to definitively prove this, however caution is still taken with patients who have had or have a linked history to a hormone related cancer and those at risk of blood clots. 

If you think HRT might be right for you, have a chat with your GP or continence specialist, who can talk you through your options and the viability.

Changes in bladder control during menopause are all-too-common, but they don’t have to define your day-to-day life. With a deeper understanding of how your body is changing, alongside simple aids like pelvic floor exercises, lifestyle changes, and the right products, it’s possible to feel in control again.

At Vivactive, we offer a wide range of incontinence products designed to help you manage leaks with confidence, at a price that’s right for you. 

Browse our full range of incontinence pads and ladies liners to find an option that fits easily into your routine, or explore our incontinence pants for a more secure, all-day solution that feels just like regular underwear. Whatever your needs, we're here to help you find the right fit.