Menopause brings many changes — hot flashes, mood swings, and sometimes unexpected bladder issues. Urinary incontinence, or leaking urine you can’t control, may not be the most talked-about symptoms, but it’s common and deserves attention. These bladder leaks can feel uncomfortable and even embarrassing, but with the right strategies, you can regain confidence and control.
Why does menopause increase the risk of bladder leaks?
Estrogen plays a key role in bladder health. It helps maintain the strength and flexibility of the bladder, urethra, pelvic floor muscles, and vaginal tissues. When estrogen levels drop during menopause, these tissues can become thinner and weaker, making bladder control harder. This hormonal shift, combined with age-related changes, increases the risk of urinary symptoms like incontinence and overactive bladder.
Did you know? About 12% of females ages 40-65 report having urinary incontinence*, and nearly of women over 70 have some form of bladder leakage.
Types of incontinence you might experience
Menopause can affect bladder function in different ways. Here are the most common types.
Stress incontinence
This involuntary loss of urine can occur when pressure is placed on the bladder and urethra, like when you laugh, cough, sneeze, or exercise. Stress incontinence happens when the muscles and tissues that help support the bladder and urethra (your pelvic floor muscles) thin and weaken over time, making it more difficult to support your bladder function. You can think of stress incontinence as a structural issue.
Urge incontinence
Urinary leakage that occurs because of a sudden, strong urge to pass urine that you can't control. It usually happens because of changes in nerve signals, causing bladder muscles to involuntarily contract at the wrong time.
It’s the urge that you (or a friend) have probably experienced when you’re arriving home, keys in the door, and don’t make it to the bathroom on time. Think of urge incontinence as a functional issue. Your body's design is normal, but the signals and coordination aren't working the way they should.
Mixed incontinence
You may have symptoms of both stress and urge incontinence.
Other types of urinary incontinence can include:
- Temporary incontinence. Often related to a short-term health problem, like a urinary tract infection, constipation, or a bladder infection.
- Functional incontinence. When a person's ability to reach the toilet on time is hindered by a physical limitation, communication impairment, or cognitive issue.
- Overflow incontinence. This happens when the bladder gets too full or doesn't fully empty, causing leaks. This can be due to a blockage, weak muscles, or disrupted nerve signals that prevent you from feeling the bladder is full.
What is overactive bladder?
Overactive bladder (OAB) syndrome happens when the bladder contracts unexpectedly at the wrong time. It can lead to symptoms such as:
- Frequent urination (8+ times a day or 2+ times at night).
- The sudden, urgent need to urinate.
- Leakage of urine after a sudden, strong urge to pee (urge incontinence).
How to improve menopause bladder issues
The good news: You can take steps to strengthen your pelvic muscles, improve bladder control, and reduce leaks. Talk to your doctor about what might work best for your type of incontinence.
Strengthen your pelvic floor
Regular pelvic floor exercises, often called Kegels, can help strengthen the pelvic floor muscles that support the bladder and urethra. Kegel exercises involve relaxing and tightening the pelvic floor muscles. The pelvic floor muscles, which are located between the tailbone and the pubic bone inside of the pelvis, help control the flow of urine.
To help identify your pelvic floor muscles, try stopping the flow of urine the next time you pee. However, it's not a good idea to regularly practice Kegels by starting and stopping your urinary flow. Performed regularly, these exercises can be particularly beneficial for stress urinary incontinence. They can also be helpful with urge incontinence by performing Kegels when the urge to urinate strikes. A good place to start is 3 sets of 10 Kegels every day.
Bladder training
The goal of bladder training is to help you regain control. You can do this by increasing the amount your bladder can hold and the time between visits to pass urine. To train your bladder, you need to repeatedly contract pelvic floor muscles (Kegel) at the time of the urge to pee. Hold the contraction for as long as the urge goes away. Practice makes perfect. This change won’t happen overnight, so be patient. And remember, practice makes perfect. These techniques can especially help with urge incontinence.
Stay hydrated
While it may seem counterintuitive, staying well hydrated can help reduce bladder irritation. Sip water throughout the day when you feel thirsty. There’s no need to drink excessive amounts.
Adjust your diet
Limit caffeine, alcohol, spicy foods, and acidic foods, which can irritate the bladder. A balanced diet supports overall pelvic health.
Maintain a healthy weight
Losing weight or maintaining a healthy weight with a healthy diet and regular exercise can help the pelvic floor muscles and bladder feel less pressure.
Manage stress
High stress levels can worsen bladder issues. Use relaxation techniques like deep breathing, yoga, and/or meditation to help reduce tension.
Consider medical options
In some cases, medical interventions may be necessary. These may include medicines to help with bladder function, local hormone therapy, interventions like neurostimulation, or surgical procedures to strengthen support for the bladder and urethra.
Seek professional help
People who are experiencing incontinence should never hesitate to seek medical advice. A healthcare provider can work with you to understand the type and severity of your bladder issue. They can also discuss treatment options. Your gynecologist is a good place to start. They may refer you to a specialist called a urogynecologist or urologist, if you need more invasive testing or procedures.
Pelvic floor physical therapy
Pelvic floor physical therapy is a specialized treatment that retrains the pelvic floor muscles (that help control your bladder) to work properly. It's more than just Kegels. Therapists use guided exercises, breathing techniques, and posture training to help improve strength, coordination, and relaxation. It can help with better bladder control, reduced pelvic discomfort, and improved confidence and quality of life.
Breaking the stigma
Education is a key part of managing urinary incontinence. Talking openly with healthcare providers, friends, and family can help you feel supported to navigate this phase of life and feel more in control…of your bladder.
*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.
FAQs
Why does menopause increase the risk of bladder leaks?
Menopause causes a drop in estrogen, which affects the bladder, urethra, and pelvic floor muscles. Injuries and aging can also lead to weakness or injury to pelvic floor muscles. These changes can lead to urinary symptoms like leaking urine or urge incontinence.
What are the different types of incontinence during menopause?
Common types include stress incontinence, urge incontinence, mixed incontinence, and overflow incontinence. Each type of incontinence has different causes and management strategies.
How can I manage urinary symptoms and prevent urinary tract infections during menopause?
Pelvic floor exercises, bladder training, staying hydrated, and maintaining a healthy weight can help. Avoid bladder irritants and talk to your doctor about treatment options.
References
Australasian Menopause Society. Urinary incontinence in women [PDF]. Accessed 12/19/2025 from https://www.menopause.org.au/images/factsheets/AMS_Urinary_Incontinence_in_Women.pdf
Bodner-Adler, B., Alarab, M., Ruiz-Zapata, A.M., & Latthe, P. (2020). Effectiveness of hormones in postmenopausal pelvic floor dysfunction—International Urogynecological Association research and development—committee opinion. International Urogynecology Journal, 31(8): 1577-1582. doi: 10.1007/s00192-019-04070-0
Continence Foundation of Australia. (2019). How your weight impacts your pelvic floor. Accessed 12/19/2025 from https://www.continence.org.au/news/how-your-weight-impacts-your-pelvic-floor
Kolodynska, G., Zalewski, M., & Rozek-Piechura, K. (2019). Urinary incontinence in postmenopausal women – Causes, symptoms, treatment. Menopause Review, 18(1): 46-50. https://doi.org/10.5114/pm.2019.84157
National Association for Continence. The surprising effects of stress on your bladder. Accessed 12/19/2025 from https://nafc.org/bhealth-blog/the-surprising-effects-of-stress-on-your-bladder
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Definition & facts for bladder control problems (urinary incontinence). Accessed 12/19/2025 from https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/definition-facts
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Prevention of bladder control problems (urinary incontinence) & bladder health. Accessed 12/19/2025 from https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/prevention
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Symptoms & causes of bladder control problems (urinary incontinence). Accessed 12/19/2025 from https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/symptoms-causes
National Library of Medicine, MedlinePlus. (2024). Overactive bladder. Accessed 12/19/2025 from https://medlineplus.gov/overactivebladder.html
National Library of Medicine, MedlinePlus. (2024). Pelvic floor muscle training exercises. Accessed 12/19/2025 from https://medlineplus.gov/ency/article/003975.htm
Rahn, D.D., Good, M.W., Roshanravan, S.M., Shi, H., Schaffer, J.I., Singh, R.J., & Word, R.A. (2014). Effects of preoperative local estrogen in postmenopausal women with prolapse: A randomized trial. Journal of Clinical Endocrinology & Metabolism, 99(10): 3728-3736. doi: 10.1210/jc.2014-1216: 10.1210/jc.2014-1216
The Menopause Society. Menopause topics: Symptoms. Accessed 12/19/2025 from https://menopause.org/patient-education/menopause-topics/symptoms
Urology Care Foundation. (2016). Bladder pain advice during IC/BPS awareness month. Accessed 12/19/2025 from https://www.urologyhealth.org/healthy-living/care-blog/bladder-pain-advice-during-ic/bps-awareness-month
Urology Care Foundation. (2024). What is urinary incontinence? Accessed 12/19/2025 from https://www.urologyhealth.org/urology-a-z/u/urinary-incontinence
Urology Care Foundation. Women, keep your pelvic floor healthy. Accessed 12/19/2025 from https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/fall-2021/women-keep-your-pelvic-floor-healthy
Weber, M.A., Kleijn, M.H., Langendam, M., Limpens, J., Heineman, M.J., & Roovers, J.P. (2015). Local oestrogen for pelvic floor disorders: A systematic review. PLoS One, 10(9): e0136265. doi: 10.1371/journal.pone.0136265
Links to other parties' articles and websites are provided for convenience only. Kenvue is not responsible for their content.
