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Staying Strong After Menopause

What does menopause mean for bladder health?

Keeping your pelvic floor healthy through all of life’s many changes is important. November is National Bladder Health Awareness Month, so what a great time to talk about how we can keep the pelvic floor strong as we age – particularly through menopause!

What’s the average age for menopause?

Menopause will affect every woman at some point in her life. While the average age for menopause to start is 52, some women can begin as early as their 30s and as late as their 60s! Technically, menopause begins when you have stopped having a menstrual cycle for 12 months. But, symptoms can start even before this begins – perimenopausal symptoms can last anywhere from a few months to several years before actual menopause starts.

What are the causes and symptoms of menopause?

Our ovaries make the hormones estrogen and progesterone, which control menstruation and ovulation. While there are a variety of other reasons other than age that can cause menopause, it typically occurs when the ovaries no longer release an egg every month, estrogen production is less, and menstruation stops. This decline in estrogen levels cause a number of changes to the body. While not all women experience symptoms related to menopause, common symptoms may include hot flashes, night sweats, pain during intercourse due to vaginal dryness, weight gain, mood shifts, and increased anxiety or irritability.

How does menopause affect your bladder?

As the ovaries stop making estrogen, vaginal tissue become less elastic, the lining of the urethra (the tube that empties urine from your bladder) begins to thin, and menopausal weight gain can cause increased pressure on your pelvic floor and bladder/bowel. Without proper care, pelvic floor muscles can become weaker, which increases the possibility of leakage. Vaginal dryness can occur as the lining of the vagina produces less mucus. And, a decline in bladder elasticity can increase bladder irritation and impact bladder function.

What can I do about it?

There are many strategies that you can use to help a positive impact on your pelvic health. Here are a few tips:

  • Practice ideal posture and belly breathing – By improving your postural awareness and strengthening your postural muscles, you will reduce your risk and impact of pelvic floor dysfunctions.
  • Manage what is within YOUR control – Maintain a healthy weight, avoid constipation, limit bladder irritants, and manage stress with whatever strategy works for you.
  • Contract your pelvic floor before you sneeze or cough to reduce the amount of downward pressure on your pelvic floor to prevent and/or reduce leakage.
  • When you have a strong urge, avoid rushing to the toilet because this causes your bladder to contract harder and you will be more likely to leak before you reach the bathroom. Instead, try to stop and sit down, do a few pelvic floor contractions, apply pressure to your perineum (either directly or crossing your legs), or do something to distract yourself.
  • In general, avoid urinating “just in case”.
  • To minimize nighttime urge, get your fluid in during daytime hours and limit fluids for 3 hours prior to bedtime. Also, taking a nap, elevating your legs, and using compression stockings help fluids get absorbed in the bloodstream so you can void during the day.
  • There are hormone options to help the pelvic region and tissues – talk with your doctor about what’s right for you.

Thankfully, there are many things that can be done to maintain pelvic health as we age. Incontinence is not “just the way life goes”! You can learn to prevent or manage incontinence, starting with taking proper care of your pelvic floor. If you are experiencing any of the symptoms that have been discussed, talk with your doctor and/or a licensed physical therapist who specializes in women’s health as soon as possible so that they can evaluate your symptoms and set you up on a proper treatment plan.

Want to know more?

At PhysioCare Physical Therapy, we are thrilled to be teaming up with the National Association for Continence ( to offer a FREE Educational Class on Menopause and the Pelvic Floor. Come join us on Tuesday, November 15th at 7 pm at our Woodinville Clinic.

RSVP is recommended, but not required to or 425-402-9772.

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