Perimenopause is a natural stage in every woman's life, but some of the symptoms can still come as a surprise. While you may expect to experience hot flushes, night sweats, mood swings, and vaginal dryness, many women aren't prepared for the possibility of urinary incontinence.
Unexpected leaks and uncontrollable urges to use the bathroom may leave you feeling betrayed by your body. However, it's important to remember that you're hardly alone in this, with 40% of middle-aged women facing the same challenges.
In this article, we'll explore why this happens and provide tips for finding relief, so you can reclaim your quality of life despite your perimenopause incontinence.
Gaining a Deeper Understanding of Perimenopause
Perimenopause is a transitional phase that takes place directly before menopause. It typically begins in a woman's 40s but can start earlier or later, depending on lifestyle factors and genetics.
During this time, oestrogen and progesterone levels fluctuate, which can lead to the following symptoms:
Hot flushes
Night sweats
Urinary incontinence
Irregular periods
Vaginal dryness
Headaches
Joint and muscle pain
Weight gain
Mood swings
How perimenopause and incontinence are linked
Declining oestrogen levels can lead to thinning of the bladder wall, which can reduce its ability to control flow. Pelvic floor muscles also tend to weaken during perimenopause, making urinary incontinence more likely.
Severity levels of urinary incontinence
During perimenopause, some women experience urinary incontinence and this can range from occasional light leaks to more frequent and disruptive episodes.
Severity levels include:
Mild: Infrequent small leaks, often during physical exertion.
Moderate: More noticeable leaks triggered by minimal pressure or urges.
Severe: Frequent or unpredictable leaks that significantly impact daily life.
What type of urinary incontinence is most prevalent in perimenopausal women?
The most common type of urinary incontinence in perimenopausal women is stress incontinence.
It’s typically triggered by physical activities like coughing, sneezing, or lifting heavy objects. Weak pelvic floor muscles often contribute to stress urinary incontinence, although other factors may also play a role.
Urge urinary incontinence, marked by sudden, uncontrollable urges to urinate followed by leaks, is also common, often linked to an overactive bladder or neurological issues.
If you experience a mixture of urge and stress incontinence, it's known as mixed incontinence.
Risk factors
Several risk factors increase your likelihood of experiencing urinary incontinence during perimenopause, including:
Pregnancy and childbirth can weaken your pelvic floor muscles.
Obesity, as extra weight puts additional pressure on your bladder, increasing your chance of leakage.
Chronic coughing puts intense pressure on your bladder.
A sedentary lifestyle weakens your pelvic floor muscles.
Genetics also play a role. Those with a family history of urinary incontinence are more likely to develop this condition themselves.
How to Relieve Your Perimenopause Incontinence Symptoms
If your urinary symptoms are affecting your everyday life, you can find relief by following these tips:
Adjust your diet
Avoid bladder irritants like caffeine, alcohol, spicy foods, and artificial sweeteners. These items can stimulate your bladder muscles and increase your likelihood of experiencing leaks from urge incontinence.
Instead, aim for a diet rich in fibre, fluids, and anti-inflammatory foods. Some of the best foods for bladder health include bananas, berries, whole grains, lean proteins, eggs, and lentils.
Pelvic floor exercises
In many cases, underused or weakened pelvic floor muscles contribute to bladder weakness. Strengthening these muscles in those with weaker pelvic floor muscles can help reduce urinary incontinence symptoms.
Kegels are one of the best exercises you can do for your pelvic floor if you have a weaker pelvic floor.. They involve contracting and relaxing your pelvic floor muscles in quick succession. It is best to consult a pelvic floor physiotherapist before starting pelvic floor exercises, as they can ensure you understand the correct technique and that you start a regimen that is personalised to your needs. After this, you may repeat this exercise multiple times a day to see results.
Prioritise your mental health
Urine leakage caused by urge and stress incontinence can be mentally draining, and it's normal to feel stressed. However, stress, anxiety, and depression can actually worsen your incontinence symptoms.
It's essential to prioritise your mental health if you want to reduce the severity of your leaks. Take time to relax by practising mindfulness, going to a yoga class, or just enjoying a good book. If your symptoms are impacting your quality of life, it is also important to seek advice from your doctor and consider talking therapy or medication to support your mental health.
Maintain a healthy weight
A healthy weight is a good place to start when it comes to improving urinary incontinence.. Excess weight puts added pressure on your pelvic organs, including the bladder, which can worsen symptoms.
A balanced diet and regular exercise can support weight loss, but if you don’t see results within a few weeks, it’s worth speaking to your doctor for guidance.
Retrain your bladder
Bladder training involves scheduling bathroom visits and gradually increasing the intervals. This method is particularly helpful for those with urge urinary incontinence, as it can help minimise urges and reduce frequency. Bladder retraining is best done under the supervision of a healthcare professional.
You may also want to keep a bladder diary to help you stay on track and take note of any unexpected leaks.
Treat constipation
Constipation can increase pressure on the bladder, leading to a higher chance of leaks. In fact, constipation is one of the most common underlying causes of urinary incontinence, and it often goes untreated.
Staying hydrated, increasing fibre intake, and staying active can help relieve this issue and reduce flare-ups. If the problem persists, you should make an appointment to see your doctor.
Managing Your Leaks
Urine leakage can be incredibly frustrating. While incontinence products won’t cure the condition, they can help you manage leaks, protect your clothing, and give you the confidence to carry on with your day.
Some of the most popular urinary incontinence products include:
Liners are typically discreet and comfortable, making them perfect for light leaks.
Incontinence pads come in a variety of absorbency levels, and are ideal for light, medium, and heavy leaks.
Leak-proof underwear is ideal for those looking for a sustainable and reusable solution for their urine leakage. These products also come in a variety of different styles.
The Treatment Options for Perimenopause Incontinence
If lifestyle changes and management strategies aren’t providing enough relief, it may be time to consider medical treatment options.
While many of these treatments don’t directly target urinary incontinence, the focus on balancing hormone levels can help ease related bladder symptoms.
Hormone Replacement therapy
Systemic hormone therapy may help restore hormonal balance and improve bladder function.
Some of the other benefits include:
Improved bone health
Better sleep
Reduced cardiovascular risk
Improved mood
Despite the impressive benefits, hormone replacement therapy is not suitable for everyone, so be sure to consult with your doctor to see if it could be a good option for you.
Vaginal oestrogen cream
Unlike systemic hormone therapy, topical oestrogen cream is applied directly to the vaginal area. Over time, this practice can rejuvenate local tissues and improve urinary symptoms.
Topical oestrogen creams can also help alleviate vaginal and vulval dryness, one of the most common characteristics associated with perimenopause.
Medication
Anticholinergic drugs (like oxybutynin) or beta-3 adrenergic agonists (mirabegron) may be prescribed to relax the bladder muscles and reduce the urgency and frequency of urination. These medications aren't suitable for everyone, so you'll need to book a consultation with your doctor to determine whether or not you're a good candidate.
Biofeedback
This therapy uses electric sensors to provide crucial information about your bladder muscles. When used in conjunction with Kegels and other exercises, biofeedback therapy can help you see massive improvements in your urinary symptoms.
Herbal remedies
Across cultures, herbal remedies have been used to reduce perimenopause and menopause symptoms.
Some of the most common herbs used in these remedies include:
Black cohosh
Soy
Ginseng
Maca
Evening primrose
These herbs can be taken as supplements or as teas. While their effectiveness is often debated within the scientific community, you may consider these as options particularly if medications are not suitable for you. Remember that herbal medication can interact with other medications and can still cause side effects, that’s why you should only consider these remedies after discussing options with your doctor.
The Impact of Perimenopausal Incontinence
Urinary incontinence during perimenopause isn't just a physical problem. Urine leakage can lead to anxiety surrounding social situations, a lack of confidence, and even depression. You may find that you no longer want to participate in once-loved activities, and shy away from making plans with friends.
Over time, this can drastically impact your mental health and emotional well-being.
This is why it's so important to find management strategies and treatments that work for you. There's no need to suffer in silence, so reach out to your support system and book an appointment with your general practitioner to get started.
FAQs
What are some of the other symptoms associated with perimenopause?
Some of the other symptoms associated with perimenopause include:
Vaginal dryness
Irregular periods
Hot flushes
Sleep issues
Weight gain
Skin problems
Joint and muscle pain
Needless to say, these symptoms can be incredibly frustrating and disruptive, but the exact symptoms will differ greatly from person to person.
Why is incontinence more prevalent in older women?
Urinary incontinence is more common in women over 50 because of age-related changes, such as menopause and hormone fluctuations. Additionally, women at this age are more likely to have experienced pregnancy and childbirth, which can weaken the pelvic floor muscles.
What habits can worsen symptoms of incontinence?
Some of the habits that can worsen your urinary incontinence symptoms include:
Drinking alcohol
Smoking cigarettes
Not getting enough sleep
Consuming bladder irritants
Lack of exercise
Bladder habits such as “just in case pees”
When should I see a doctor about my urinary incontinence?
Whether you're experiencing the occasional leak or frequent "accidents", you should make an appointment to consult with your general practitioner. The sooner you can get a diagnosis, the sooner you can start addressing your symptoms with an effective treatment plan.
Are menopause symptoms different to perimenopause symptoms?
Perimenopause and menopause share similar symptoms, such as hot flushes and mood changes, but they occur at different stages.
Perimenopause is the lead-up, marked by fluctuating hormones and irregular symptoms. Menopause begins after 12 months without a period, when oestrogen levels drop. Some symptoms may persist, while others may change. Each person experiences these stages slightly differently.
What are the other urinary issues experienced by menopausal women?
In addition to urinary incontinence episodes, women going through perimenopause and menopause may experience frequent urination, urinary tract infections, overactive bladder symptoms, and general bladder weakness.
Final Thoughts
No matter how prepared you are for this phase of life, perimenopause can be filled with unexpected challenges. From night sweats to urine leakage, it's common to be distressed by these uncomfortable symptoms.
Here at Jude, we're dedicated to smashing the taboos surrounding women's bladder-related conditions. By filling our blog with informative content about symptoms, management techniques, and treatment options, we hope to break down social stigmas.
Additionally, we offer a range of specialised incontinence products that are designed to bring you comfort, confidence, and relief. Just because you're going through perimenopausal incontinence, it doesn't mean you shouldn't enjoy your life to the fullest.
