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Incontinence….Ah Hem…Let’s Talk About It


I know you probably don’t want to talk about incontinence. In fact, it’s possibly the last thing you want to talk about – but during menopause it really can be a ‘thing’.

One of the many that nobody talks about. However, incontinence or ‘just-gotta-go-now’ is one of the signs of menopause. It’s very common.

Argh, I hear you cry.

I know, I know, not nice.

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Let’s take a look at the why’s and wherefores because knowledge is a wonderful thing.

Firstly, know that it’s the changes in our bodies that cause urinary issues.

To elaborate, the menopausal years are a time when our ovarian estrogen production diminishes. When we lose estrogen our vagina becomes less elastic. According to WebMD the lining of your urethra, the tube that empties urine from our bladder, begins to thin. 

Another thing that happens is a weakening of our pelvic floor – muscles that support our urethra and bladder. This also happens with age and giving birth.

We may experience a number of different types of incontinence:

Stress incontinence

You know the one? You laugh, cough or sneeze and ‘oops’ a leak! Or you’re lifting something heavy? This often happens after giving birth as well.

Urge incontinence

Oh, this one’s a doozy. The ‘urge’ comes on without warning and you just have to go. It doesn’t care where you are or what you’re doing. WebMD says this is often called an ‘irritable’ or ‘overactive’ bladder as well.


Have you heard of this one? I hadn’t either, but it’s when you wake up several times during the night and have to go to the bathroom.

Painful urination

When we were in our 20s this was referred to as ‘honeymoon disease’ but now we’re in the meno years it’s just called discomfort! Most of us are familiar with the discomfort of UTI’s or urinary tract disease (aka cystitis), and we become more prone to them during menopause.

What can you do?

  1. Maintain a healthy weight. Extra weight equates to more pressure on your bladder. End of story.
  2. Check your liquid intake. Some drinks, like coffee, are diuretics and fill your bladder quickly. Fizzy drinks and alcohol do the same thing. Alcohol makes the bladder more sensitive. Water is best. Of course, it fills the bladder as well but it causes fewer side effects.
  3. Have a cut-off time for what you drink during the evening. This helps to stop night waking.
  4. Exercise your pelvic floor. Kegel exercises tighten your pelvic floor muscles which can have many other benefits as well as bladder control. You can learn how to do them by stopping your urine mid-flow. Once you’ve got the hang of it do your Kegels while you’re driving, sitting or whenever you think of it. Start with 10 two or three times a day and build up.
  5. Zinc, vitamins C and D, magnesium and D-Mannose have all been found to be helpful with incontinence. The D-Mannose is particularly helpful for urinary tract infections (UTI’s).
  6. Invest in an Elvie.  Australia. New Zealand
  7. Invest in some pads or special panties.

NB: don’t make a habit of doing your kegel’s on the loo, as it’s not a good idea to block your flow routinely.

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This is the time when menstruation is well and truly over, the ovaries have stopped producing high levels of sex hormones and for many ladies, perimenopause symptoms subside.

Estrogen has protective qualities and the diminished levels mean organs such as your brain, heart and bones become more vulnerable. It’s also a key lubricant so your lips may become drier, your joints less supple and your vagina might be drier. In addition, your thyroid, digestion, insulin, cortisol and weight may alter.

At this juncture, a woman might experience an increase in the signs of reduced estrogen but she should have a decrease of perimenopause symptoms. That said, some women will experience symptoms like hot flushes for years or even the rest of their lives.


Peri = ‘near’

Most females begin to experience the symptoms of perimenopause in their mid-forties. Your progesterone levels decline from your mid-30s but it’s generally from around 40 that the rest of your sex hormones begin to follow suit. 

Perimenopause is a different experience for every woman and some women may barely notice it. The first indicators are usually changes to the monthly cycle. This means that for some ladies, this can be accompanied by things like sore breasts, mood swings, weight gain around the belly, and fatigue as time goes on.

For those with symptoms it can be a challenging time physically, mentally and emotionally.

Importantly, perimenopause lasts – on average – four to 10 years. The transition is usually a gradual process and many women enter perimenopause without realising.