This article is written by Dr. Masarat Jilani, a junior doctor who is passionate about challenging stigma and empowering patients through media.
People don’t talk about the menopause. It is seen as something which you just must ‘put up’ with. This used to leave many suffering in silence or not understanding why it wasn’t easy to cope but luckily, this is slowly changing. Still, bladder leaks remain taboo even though they can affect many women going through the menopause. With so many women experiencing bladder leaks yet not seeking help - many have called bladder leaks the last taboo.
Bladder leaks are not inevitable, they are not ‘normal’ and you do not have to put up with them in silence.
Does the menopause increase bladder leaks?
One of the biggest hormonal changes during the menopause is a drop in the hormone oestrogen. This hormone starts to drop before women fully enter the menopause. Oestrogen helps with bladder health and the drop can leave your pelvic floor weaker. This can result in bladder leaks. It can cause the vaginal tissues to become thin leading to dryness as well.
What types of bladder leaks affect menopausal women?
The two most common types are stress incontinence and an overactive bladder. Some people may have a mixture of the two. There are also other types of incontinence including overflow, functional and reflex. These will be discussed in other blog posts.
Stress incontinence is when you leak when you sneeze, laugh or exercise and it can really affect your life. Nobody wants to worry about leaking when they are having a laugh or when they are having fun with family or friends.
Overactive bladder is when you find yourself constantly or suddenly feeling the urge to pee, having to pee more frequently than normal or peeing at night.
Our guide to dealing with bladder leaks during the menopause
Talk to your doctor - Your doctor can help diagnose what type of bladder leaks you are having and make sure you do not have an underlying health condition. We know it’s not easy to talk about this, but we have a mini guide in our previous blog post. You can find it here.
Maintain a healthy weight - We know this can be difficult, especially as we get older. But we still have some tips on how to try. As most of us know, the best way to have a healthy weight is to maintain recommended calorie intake for your height and exercising regularly. Do whatever type of exercise you enjoy whether that’s walking, swimming or aerobics. Focus on what you enjoy to make the experience fun and a regular part of your life. Swap higher calorie versions of your foods for lower ones and include more fruit and vegetables in your diet. Don’t feel guilty if you have setbacks. Persevere with small changes and we know you will reach your health goals!
Discuss HRT with your doctor - HRT can be a solution for some people to tackle most of the symptoms associated with menopause. Some people opt for an oestrogen gel to apply to the vagina to help with dryness. The gel only acts locally so there are minimal side effects. Whether you decide to choose HRT or not, it is always worth speaking to your doctor about it. If you want more information about HRT then we recommend checking out the menopause doctor’s website which has lots of useful information.
Retrain your bladder - Bladder retraining is a programme of changes which your GP should be able to advise you about. For example, if you find yourself going to the bathroom 30 times a day, then try to plan 27 times equally spread out through the day. Try to hold your pee in and not go to the bathroom apart from those 27 times. Try this for a few days. Then, reduce to 24 allotted breaks and try that for a few days. Keep gradually doing this until you reach 6 - 8 times a day. Let us know if you're interested to learn more about this and we can dedicate a full blog post to bladder retraining tips.
Practice pelvic floor exercises - Because the reduction in oestrogen reduces the tone of the pelvic floor muscles, they can become weaker and more sensitive to pressure. But pelvic floor exercises can combat this! It’s recommended that you do 10 sets of squeezes 3 times a day. The best time to do them is when you are lying down. Remember to squeeze the muscles shut and lift them up! We’ve mentioned the Squeezy app before - if you're looking for guidance, this is an NHS approved app that helps you work on strengthening your pelvic floor.
Try incontinence underwear - Incontinence underwear is designed to allow a more confident experience when dealing with bladder leaks. We do have our own incontinence underwear and it is fantastic - if we do say so ourselves. To find out more about our product, sign up to the mailing list. You can also try pads but do not use sanitary pads! Sanitary pads are designed for the flow of blood i.e. it has slower absorption and holds way less liquid. It’s best to use a product which is designed for bladder leaks rather than periods.
Maintain a good level of hydration - Counter intuitive we know but, staying hydrated is important for your health - most of us should be drinking 1.5-2L of fluid every single day! Following thirst cues is the best way to ensure you stay hydrated.
Practice self-kindness - This is so important especially during the menopause. Your body is going through a change, so treat yourself with kindness and love. Remember, your body has gotten you through the ups and downs of life and it may need a little more attention now. Never feel guilty for the bad days but, remember that every day is a new day. If you need a lie-in that’s okay. If you’re feeling emotional, that’s okay. And if you are struggling, that’s okay! But most importantly, remember you are not alone; many women will be in a similar position. Reach out and you may be surprised at the support you find! And don’t forget Provie is here to support you every step of the way too.
If you have any questions or need support around bladder leaks, feel free to leave a comment or contact us for help.