The menopause and your bladder

The menopause and your bladder

  • On June 22, 2016

Most women know that the menopause can bring hot flushes, night sweats, mood swings and sleep problems, but it seems fewer women associate the menopause with bladder problems.

Bladder weakness

As women enter menopause the muscles and ligaments that support the pelvic floor become weaker. These tissues are sensitive to oestrogen so as oestrogen levels fall they lose their strength and elasticity. This means that even small increases in pressure such as coughing, sneezing, laughing or even running can cause leakage.

Exercising the pelvic floor can help and the good news is that it’s never too late to start. When exercising your pelvic floor you are trying to mimic the sensation that you would have if you were trying to stop weeing mid-stream.

Overactive bladder

When you have an overactive bladder, you will get very little warning of the need to empty your bladder and sometimes if you can’t get to a toilet quickly enough, you may experience a leak. What I let my patients know is that it is a very common condition experienced by women of all ages but is increasingly common in menopausal women.

Pelvic floor exercises will help and there are several lifestyle factors that can influence the condition too. If you are carrying extra weight, losing a few pounds will help. Nicotine, caffeine, alcohol and fizzy drinks also irritate the bladder lining so cutting back on these is a good idea. It is not a good idea to cut back on your fluid intake as concentrated urine is more irritating to the bladder lining and not drinking enough can make things worse, so always aim to keep your urine the colour of straw.


Around 50% of all menopausal women experience weakening of the front wall of the vagina, a quarter have weakening of the back wall of the vagina and a fifth will have weakness at the top of the vagina. This can lead to prolapse, which can cause pressure effects on the bladder meaning you may feel the need to urinate more frequently or may feel that your bladder isn’t emptying properly.

Pelvic floor exercises will prevent the condition getting any worse but once a prolapse has developed your GP may be able to fit a pessary or there operations which can be done.