Why Does Menopause Cause Incontinence? 3 Reasons to Know

Last updated 03.07.2024 | by Sabrina Johnson | 9 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

A leaky bladder or the inability to hold urine can often leave you embarrassed in public. The term urinary incontinence isn’t unknown to many, right? For those unaware, urinary incontinence is the inability to control your bladder, which causes urine to leak unintentionally. Urinary incontinence is more common in women than in men.

Let’s look at some data here. Around 20-30% of women suffering from it are young, 30-40% are middle-aged, and 50% of them are older women. If you observe the data, you will see that the percentage of middle-aged and older women experiencing urinary incontinence is higher than that of younger women.

That’s because, by that time, most women have gone through pregnancy, which has weakened their pelvic floor muscles, lessening their ability to hold urine well. Menopause and the phase when women are transitioning into it is another reason behind urinary incontinence.

I was conscious about keeping my pelvic floor muscles healthy right after my 30s and would exercise regularly. So fortunately, urinary incontinence did not affect me much. However, for my sister, it wasn’t the same. A leaky bladder had become a cause for her concern in her early 50s.

Are you of menopausal age and worried about urinary incontinence? Then, this is the perfect article for you. I have covered all aspects, including the cause of urinary incontinence in menopause, the types of urinary incontinence, and how to manage it. Read on to learn more.

Why Do Women Experience Urinary Incontinence in Menopause?

Why Do Women Experience Urinary Incontinence in Menopause?

I have elaborated on some of the reasons that may trigger urinary incontinence in women during menopause.

Low Estrogen Levels

One of the highlighting aspects of menopause is the reduced estrogen levels. The declining levels of this hormone impact the pelvic floor muscles, which eventually weaken. The muscles lose their capacity to control your bladder as effectively as before.

Moreover, low estrogen levels also result in the thinning of the urethra, making women susceptible to urinary incontinence and UTI (urinary tract infection) as well. When you have urinary incontinence, it worsens with menopause.

Underlying Health Issues

Because of the low estrogen levels, your bowel movements could get affected, manifesting as constipation or diarrhea. If you are constipated quite often, it will impact your bladder control, resulting in urinary incontinence. The reason behind this is that when you are constipated, you strain a lot, which weakens your pelvic floor muscles. Neurological problems are also responsible for urinary incontinence.

Hysterectomy, where your uterus is removed through a surgical procedure, weakens the pelvic floor muscles, often leading to urinary incontinence as an aftereffect. The side effects of medicines like anti-depressants, diuretics, and antihistamines may also cause urinary incontinence.

Increased Weight

When you are overweight, it weakens the muscles of your pelvic floor, and the fatty tissues exert pressure on the bladder. This causes urinary incontinence. If excess weight has caused urinary incontinence, losing weight will improve your bladder function. Menopause triggers weight gain, so you must attempt to shed those extra pounds you may gain.

Types of Urinary Incontinence

Types of Urinary Incontinence

Let us look into the types of urinary incontinence based on the kind of urine leakage you experience:

  • Stress Incontinence: This happens when there is urine leakage during physical activities like laughing, exercising, coughing, sneezing, or lifting heavy objects. If you are wondering why it is called stress incontinence, there is a reason. There’s urine leakage when there is stress on the bladder because of any activity or movement.
  • Functional incontinence: When one is impaired physically or mentally, one can’t make it to the toilet on time, which may result in functional incontinence. For instance, if you have arthritis or trouble walking, you may find it challenging to go to the toilet or unbutton your trousers quickly.
  • Urge incontinence: As the name suggests, urge incontinence occurs when there is an intense urge or desire to urinate. The involuntary loss of urine often precedes it. In addition to menopause, you could have urge incontinence due to minor infections or severe reasons like diabetes or neurological issues.
  • Overflow incontinence: Some women have an urge to empty their bladder, but they aren’t able to do it thoroughly. Only a little urine is eliminated at a time. When your bladder becomes full, excess urine may leak or dribble frequently.
  • Mixed incontinence: One could experience multiple types of incontinence at a time. Mostly, it is stress and urge incontinence together.

In menopause, most women experience stress or urge incontinence triggered by weakened pelvic floor muscles.

So, if I were to sum up the symptoms of urinary incontinence in a nutshell, here they go:

  • Leaking urine, especially during any physical activity
  • Frequent urination
  • Uncontrollable and sudden urge for urination

Urinary Incontinence Management Tips

Here are some tips to help you manage urinary incontinence. Following them will also lessen your chances of being affected by it.

  • In UI, the pelvic floor muscles become weak. Your healthcare provider may suggest pelvic floor exercises, which will be helpful to those with stress and urge incontinence. You could do pelvic floor when sitting, lying, or standing.

Contract your muscles for around ten seconds, and then relax them slowly for ten seconds. As a beginner, you may start by contracting and relaxing for two to three seconds, then increase it to five and eventually ten.

Try doing three sets of pelvic floor exercises ten times in a row. To benefit from them, you should continue for at least three months. Pelvic floor exercises helped me a great deal when I was transitioning into menopause.

  • Smoking isn’t good for menopause. It aggravates symptoms like hot flashes, sleep issues, etc. It isn’t suitable for urinary incontinence either. Smoking causes coughing spasms, which may irritate the bladder and worsen incontinence.
  • Avoid lifting weights, as they strain your pelvic floor muscles, making you more susceptible to incontinence. If you must pick up kids or lift bags with weight, tighten your pelvic floor muscles first. A pelvic belt may help you in this regard. Whenever I had to carry my kiddos, I would take precautions and wear the belt. It exerted less pressure on my pelvic region.
  • As mentioned, excess weight could trigger urinary incontinence or worsen it in people already with this concern. So managing your weight by eating healthy and exercising well is essential to maintain a proper weight. I had gained around 4 pounds in my early 50s in a go. It raised the panic button in me. Altering my lifestyle helped.
  • Menopause may often lead to constipation in some due to fluctuating estrogen levels. Whether you had constipation before or developed it due to menopause, you have to be conscious. Never strain a lot during a bowel movement.

Working on your fiber intake and exercising well may help improve constipation. The position in which you sit during a bowel movement is also important, [particularly when constipated. Studies have shown the effectiveness of hip-flex sitting in lessening abdominal strain. Talking to your physiotherapist in this regard may help.

  • Alcohol, coffee, and beverages containing caffeine, like fizzy drinks, green tea, energy drinks, etc., must be avoided, especially if you have urinary incontinence. They irritate your bladder, worsening your condition.
  • We often think drinking too much water could worsen urinary incontinence. That’s a misconception. When you lessen your fluid intake, it may reduce your bladder’s capacity, worsening incontinence. Moreover, when you do not drink sufficient fluid, you can get constipated. That may aggravate urinary incontinence. However, it is better to drink water in small amounts throughout the day than gulping all of it in a go.
  • Some foods could exacerbate the symptoms of urinary incontinence. These include spicy foods, salsa, tomatoes, onions, and water-rich foods like watermelon, strawberries, and cucumber. If you have urinary incontinence, you must be cautious about having these foods. You may ask the doctor about a diet to follow.
  • Fix a proper toilet schedule. You should urinate every 2-4 hours, even if you don’t feel the urge to go. This will help you fix your urinary incontinence, especially if it isn’t severe.


How to treat urinary incontinence?

Your healthcare provider will suggest a treatment procedure depending on the kind and severity of your incontinence. Some medications used to treat urinary incontinence include anticholinergics, which help calm your overactive bladder. Alpha-blockers and topical estrogen are available as patches, creams, and rings.

Electric stimulation is used when urinary incontinence is severe and doesn’t improve with other treatment methods or management procedures. Some medical devices used for treating urinary incontinence in females include urethral inserts and pessaries. In extreme cases, when urinary incontinence makes daily living difficult, surgical procedures might be needed.

How is urinary incontinence diagnosed?

Your doctor will hear your problem and the symptoms you experience. He will conduct a physical examination. Then, according to the severity, he may recommend tests like urinalysis. He will ask for your urine sample to check for infections.

He may even ask you to maintain a bladder diary containing information like your water intake, amount of urination, and how often you have urinary incontinence episodes. Your doctor may even conduct a residual urine measurement. You’ll have to urinate in a container measuring urine output.

Your doctor will then examine the amount of urine in your bladder using an ultrasound or catheter. If your bladder has a lot of leftover urine, it means that your urinary tract is obstructed or there’s some issue with your bladder muscles or nerves.

Can hormone therapy help to control urinary incontinence?

Research has shown the benefits of hormone replacement therapy in improving the symptoms of urinary incontinence. However, it is always advisable to consult your doctor, who will be the perfect person to say if HRT could help improve your UI symptoms. The doctor will also suggest the type of HRT suited for UI alongside the correct dosage.


I understand that UI is a distressing feeling, often disrupting your peace of mind. However, if it happens to the extent that it hampers your daily living activities, do not hesitate to consult the doctor. Early intervention will help you relieve your symptoms soon.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.

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