How is the Women's Health Crisis Affecting Your Bladder Health?

In the UK today, our access to care for bladder and pelvic floor issues is heavily skewed, and it’s putting us at a serious disadvantage - and in part that’s because of the crisis in women’s health care. Due to a lack of insight, funding and research into common causes of bladder weakness in women, we often find ourselves waiting on long lists and navigating a system of prolonged diagnosis. And of course, the upshot is that many of us revert back to the silence of managing conditions like this at home, alone. 

What’s the Difference? 

Urology departments across the country have long been set up to treat conditions commonly associated with male patients - think prostate issues, bladder cancer, and erectile dysfunction. These are important health concerns, and rightly the systems to support them are robust. Urologists are widely available, with dedicated clinics, streamlined pathways, and often shorter waitlists in many Trusts with 59% of patients seen within the 18 week target set by the government.

Sadly, women frequently find a different experience when seeking help with their bladder issues. Many report that they have been told that leaks and urgency are part of ageing, to do pelvic floor exercises and cut down on caffeine. There’s an assumption that it’s a ‘normal’ part of being a woman - especially if you have recently given birth, or are going through the menopause. If we’re lucky, we might eventually be referred to a urogynaecologist - but only if that service exists locally. In many parts of the UK, it simply doesn’t.

Is Urogynaecology under Strain?

As Urogynaecology sits uneasily between gynaecology and urology, it doesn’t fit neatly into either camp and as a result struggled to receive the funding or structural support needed. 

NHS wait times for urogynaecology appointments often exceed 12 to 18 months -  and that’s just for an initial consultation, but understanding the exact number of patients waiting on a list for urogynaecology is tricky as it's lumped into gynaecology in terms of data. What we do know is that as of December 2024, there were 586,013 patients waiting to be seen, and this can only mean that while we wait for that appointment, our symptoms get worse, our quality of life deteriorates, and in some cases, the delay can lead to more complex surgical needs down the line.

Why Timing Matters for Early Interventions

Postpartum is one of the most vulnerable times for our pelvic health. For some of us, childbirth brings trauma to the pelvic floor - tears, nerve damage, prolapse. Ideally, we’d be offered early assessment, access to specialist physiotherapy, and a clear referral route if symptoms persist (as happens in France, for example). Too often, women are told it’s normal to leak after giving birth, to wait and see, do your kegels and give it time. Unfortunately, by the time we’re taken seriously, the opportunity for early intervention has passed.

Menopause is another time when we might see an impact on our pelvic floor and bladder health (and previous postpartum issues from years ago might be rearing their head, too). Falling oestrogen levels affect the strength of our pelvic tissues, the tone of our bladder, and the support around the urethra. We might notice sudden urgency, difficulty holding urine overnight, or painful UTIs that keep recurring - all symptoms of GSM, or genitourinary syndrome of menopause. And again, it can feel like a battle to find help. 

The Imbalance Reflected in Women’s Healthcare

We deserve care that takes our health seriously - and that includes our bladders. Bladder health isn’t a luxury or a niche concern; it’s affecting a third of women. We know only too well the impact on our confidence, our ability to work, socialise, sleep, travel, exercise, and enjoy intimacy. It impacts our mental health, our relationships, and how we see ourselves.

The disparity between urology and urogynaecology reflects a deeper imbalance in how our sex can determine our experiences when seeking help, and this is reflected across women’s healthcare at present. Too often, pathways that are established for men’s issues aren’t available in some areas for women, or there is a tendency to underplay the severity and impact on our lives. 

Is There Hope Ahead?

Yes - fortunately, things are looking better as we move forward and the crisis in women’s healthcare garners more attention both politically, and publicly. Women’s Health Hubs have rolled out across the country, giving local, specialised care for women for a variety of issues, such as endometriosis, menstrual health and menopause - and include services for incontinence and urinary tract infections. Funding for research and treatment for gynaecological conditions such as endometriosis has tripled since and this has increased funding for urogynaecology, too - in fact in 2023/24, this had increased from 8.9% in 2019 to 21.9%. All positive signs of change, certainly.

Awareness of bladder issues - something Jude is passionate about, especially - means that advocacy is easier than it has been for a long time. Developments in the third sector and healthcare technology means that there are more options for those of us struggling to find relief from our bladder weakness and incontinence, too.

It's Time to Flush out the Inequality 

We need to speak up - and we need the system to listen to women’s experiences and symptoms. We shouldn’t have to wait years to manage leaks or live with discomfort. We shouldn’t be told it’s normal to lose control of our bladder just because we’ve had children or reached a certain age. We deserve timely, effective treatment and for women’s bladder health to be prioritised in the same way that men’s urinary health is. We need more training posts for specialists, better access to pelvic health physiotherapy, properly funded menopause care, and a national strategy that recognises bladder health as a key component of our wellbeing.

It’s time to flush out the inequality and demand better care for our bodies, our health, and our lives.