Did you know that bladder issues can appear or get worse during perimenopause (the years leading up to menopause) and beyond?

Unfortunately, one of the two primary risk factors for urinary incontinence is increased age, according to the North American Menopause Society. (The other is vaginal childbirth.) This helps explain why bladder leaks are so common in mid-life. Nearly half of women older than 50 reported urinary incontinence in one study on healthy aging.¹  So why does the risk of urinary incontinence increase as we age?

Why it happens

There are many types of incontinence and contributing factors, but as we age, we experience changes in two areas which can put us at risk:

Pelvic floor muscles. The pelvic floor is a bowl-like network of muscles and tissue that site under and support the bladder, bowel, and uterus.  If they become weak, lose their tone, or if you lack control of these muscles, you may experience bladder leakage. Unfortunately, they tend to lose tone and weaken with age.

Hormones.  Estrogen is the primary female hormone produced by your ovaries. As estrogen levels fluctuate in perimenopause and then decline, the lining of the urethra (the 1.5 inch – 2 inch long tube that empties urine from your bladder and out of the body) can thin and lose elasticity, which can worsen urinary incontinence.

What you can do

Although bladder leaks are common for women as we age, it’s not an inevitable result of aging. It’s not something we should just accept. We can take action to treat it!

Talk to your healthcare professional. There are different types of bladder issues and many contributing factors. Your healthcare team are your partners assessing what’s happening with you and can help you explore options to find relief.

Educate yourself on options. There are many treatments for bladder leaks, depending on the cause/type and severity, ranging from at-home steps to take, to medical treatments.

By Leah Fulker, PT, DPT

As a pelvic floor physical therapist, I’ve heard countless times from so many women:

• I thought my leaks were no big deal, until they got worse!
• This is affecting my confidence …. and my relationship with my spouse
• I don’t feel as free to do the things I like to do. And everything needs to be PLANNED:
  • What to wear: Is this fabric too revealing?
  • What to bring: Do I have enough pads?
  • Where to go: Where are the bathrooms?
• Why didn’t I get help sooner?

I’ve seen patients who seek out help right away when they start to experience bladder leaks. I am always happy when women seek help sooner, when issues are often easier to treat. But more often, I see those who have been suffering with bladder leaks for many, many years!

The cost of putting of treatment

As a healthcare provider, I wish so badly that these women had help sooner. There are too many reasons to list why women don’t seek help … thought it was normal? Maybe your mom and friends have it too? Too embarrassed to bring it up to your doctor? Thought your leaks weren’t “bad enough”? There are so many reasons women just cope with leaks instead of treating leaks.

But left untreated, bladder leaks don’t usually go away on their own. How many times have we ignored our back pain or shoulder pain? Did it go away on its own? Not likely. Same happens for urinary incontinence. Incontinence usually doesn’t just get better on it’s own. In fact, it often gets worse.

Even small leaks can have a big impact 

I’ve seen first-hand how even “small” bladder leaks affect women’s social lives, activities, confidence, even relationships with partners. I’ve had women in the clinic that were even too embarrassed to be sexually active because of fear of leaking urine. Most commonly, I hear “I just stay home now” …starting an endless cycle of pelvic floor weakness, sadness, pain, and so on. We must break this cycle!

Beyond hearing what women experience, I have also seen the medical studies. They are sobering:

• Women who develop SUI during pregnancy are 579% more likely to have stress urinary incontinence (SUI) 1-year postpartum. ¹
• Women with incontinence have a 41% urinary tract infection (UTI) rate vs 9% without incontinence.²
• Urinary incontinence is a strong indicator of functional problems later in life. ³ A 2017 study on female nursing home residents in Switzerland found over 50% of the women had urinary incontinence upon admission and more than 80% needed help with their activities of daily living.

Let's take control 

These are all things we want to avoid. The bottom line is, we shouldn’t have to just accept this as an inevitable part of being a woman! Just because we had kids and all of us are getting older, doesn’t mean we have to live with the burden of buying pads or being too afraid to remain active anymore! These risk factors have been proven to lead us down a road of isolation, loneliness, depression, inactivity, and weight gain…time to say NO MORE!

There are so many things women can do to take back control. Make an appointment with your healthcare provider, see a pelvic floor physical therapist, do pelvic floor exercises (if that’s what’s right for you), consider at-home treatments like Flyte, and remember that it’s never too late to get help! Let’s not “just live with it” and “buy these pretty pads” – instead let’s TREAT this problem! We deserve to live happy, healthy, active lives!

1 Gill, B., Moore, C. and Damaser, M., 2010. Postpartum stress urinary incontinence: lessons from animal models. Expert Review of Obstetrics & Gynecology, 5(5), pp.567-580.

2 Raz, R., 2011. Urinary Tract Infection in Postmenopausal Women. Korean Journal of Urology, 52(12), pp.801-808.

3 Schumpf, L., Theill, N., Scheiner, D., Fink, D., Riese, F. and Betschart, C., 2017. Urinary incontinence and its association with functional physical and cognitive health among female nursing home residents in Switzerland. BMC Geriatrics, 17(1).