Navigating Bladder Leaks During Menopause: Understanding and Managing This Common Issue

Introduction: Understanding Bladder Leaks in Menopause

Bladder leaks. They’re common, can start after we have children (that’s trampolining out) and tend to step up a lot with the loss of oestrogen at menopause.

The Link Between Menopause and Bladder Health

We’ve talked a lot about the loss of blood flow to the pelvis, genitals and pelvic floor after menopause. The bladder sits in the same zone and also gets impacted by all this – and by the change in local oestrogen levels too.

It thins and gets weaker, and the muscular ring keeping it shut gets affected too. The pelvic floor supports this and tends to be less effective at controlling the release of urine as we age – unless we focus on keeping these muscles strong.

Impact of Bladder Leaks on Lifestyle and Wellbeing

Fear of leaking impacts quality of life. Women change habits and hobbies because of it. They learn where all the public toilets are, just in case.

Connection Between Bladder Leaks and Sexual Health

We also know that leaks are linked to sexual issues. Directly – because leaking during sex, or at climax (climacturia) is quite common, and women are often too embarrassed to tell anyone. They prefer just to avoid getting intimate instead.

Leaks affect sex indirectly too – the same processes of loss of oestrogen/blood flow affect nearby nerves and structures involved in arousal and climax. They cause distraction due to anxiety about leaking: when our brains are focused elsewhere, arousal falls. Climax can go out of the window.

Comprehensive Strategies for Managing Bladder Leaks

What can you do? Here’s a list of choices. Some, or all together, will help:

Lifestyle Changes and Home Remedies for Bladder Support

• Systemic HRT – improves blood flow and hormone levels
• Local HRT – improves hormone levels in the bladder and genital area
• Pelvic floor exercises – improves blood flow and strength of supporting structures
• Avoid bladder irritants – alcohol and caffeine make things worse
• Bladder drills – sometimes there’s a mix of urge incontinence and stress leak. Bladder training helps here
• Empty your bladder before sex – though arousal fills it a little again, this will help confidence with a partner and reduce leak likelihood

Medical Interventions for Bladder Control

• Try medication – there are drugs to support bladder function, though they can have side effects that need discussing honestly with you
• Pessaries/surgery – sometimes a game changer

How’s your bladder holding up? Let us know