Urinary incontinence

• While menopause symptoms such as hot flushes and sleep disturbances are widely discussed, incontinence is less frequently mentioned. Yet, half of all women experience it.
• As the body produces less oestrogen, the pelvic floor muscles can weaken. Oestrogen plays a role in the growth and repair of muscles in the body.
• Without specific training of the pelvic floor muscles, their strength can gradually decline during menopause, worsening incontinence.
• The term "stress incontinence" refers to involuntary urine leakage caused by physical activities (such as coughing, sneezing, or laughing) that increase pressure on the bladder.
• Pelvic floor exercises can help reduce symptoms. Supplements and hormone therapy may also provide relief.

Incontinence during menopause is primarily caused by the weakening of the pelvic floor muscles. These muscles support the bladder, bowel, and uterus. They are responsible for holding in urine and prevent leakage by contracting, for instance, when you sneeze, jump, or lift something. During urination, the muscles relax, allowing you to empty your bladder.

It’s normal for pelvic floor muscles to weaken after pregnancy and as you age. During menopause, as your ovaries produce less oestrogen and progesterone, the pelvic floor muscles may weaken further. The decline in oestrogen, in particular, plays a significant role.

Oestrogen is a vital hormone involved in muscle growth and repair. When oestrogen levels drop, it affects your muscles, including the pelvic floor muscles. The function of the sphincter muscles and surrounding connective tissue also diminishes, which can lead to involuntary urine leakage.

A study by Kołodyńska, Zalewski, and Rożek-Piechura (2019) estimates that up to 50 per cent of all women in menopause experience incontinence. Without targeted training of the pelvic floor muscles, their strength can gradually decline during menopause, worsening incontinence.

During menopause, other bladder issues may also occur, such as needing to urinate more frequently. This is because low oestrogen levels make the body more sensitive to various irritants in the urine.

Additionally, the pH level around the female genital area increases, leading to reduced blood flow to the mucous membranes. This is again due to the drop in oestrogen. The mucous membranes become thinner, drier, and more sensitive. This makes it easier for bacteria and pathogens to enter, increasing the risk of urinary tract infections, bladder infections, and vaginal yeast infections.

There are several ways to effectively manage menopause symptoms. You don’t have to live with them. You can support your body naturally with healthy nutrition, sufficient exercise, and rest. Additionally, supplements, pelvic floor exercises, and hormone therapy (HRT) can help. Below are the different options to reduce urinary incontinence.

When your hormonal balance changes during menopause, it can affect your energy levels, sleep, digestion, and metabolism. Healthy nutrition, sufficient exercise, and rest can help prevent or alleviate symptoms. Small adjustments can already make a noticeable difference in how you feel.

Do you take medications or supplements? A balanced lifestyle supports your body in absorbing nutrients and processing medications, making supplements and medications more effective. Experts recommend the following for urinary incontinence:

• Do pelvic floor exercises. You can perform these with a physiotherapist or at home. This blog provides more information on relieving symptoms with pelvic floor exercises and which exercises to try. Without training, the strength of the pelvic floor muscles can gradually decline during menopause, worsening symptoms.
• Exercise regularly. Activities such as yoga, Pilates, swimming, cycling, and running are particularly beneficial for the pelvic floor muscles. With targeted exercises and sufficient movement, you can strengthen your muscles.
• Are you overweight? Excess weight increases pressure on the bladder and pelvic floor, which can worsen stress incontinence symptoms. In this case, exercise is also important for weight loss.
• Avoid jumping and heavy lifting. These activities strain the pelvic floor and increase the risk of incontinence.
• Try vaginal weights or balls. These weights or balls are inserted into the vagina. The weight strengthens your pelvic floor muscles because you need to contract the muscles to hold the weight in place.

Replenishing the hormones that decrease during menopause is the most effective treatment for various menopause symptoms. Hormone therapy (HRT) directly addresses vasomotor symptoms such as hot flushes and night sweats, as well as vaginal symptoms like dryness. It can also indirectly improve other symptoms, such as sleep problems, concentration issues, and urinary incontinence.

HRT is not the first choice for everyone. A doctor will always carefully assess whether this treatment suits your health and symptoms.

During menopause, processes such as energy production, muscle building, and skin repair change. You can naturally support these processes with high-quality supplements. Magnesium, vitamin D, and omega-3 are recommended for every woman going through menopause. Supplements can also target specific symptoms, such as hot flushes, poor sleep, and urinary incontinence.

The effectiveness of supplements depends on factors such as your lifestyle and health. Results can also vary from person to person. The quality of the product also determines how well it works. Therefore, choose high-quality supplements without unnecessary fillers.