Complete Symptom Guide to Menopause and Urinary Incontinence - Stella

Menopause incontinence


Losing control of your bladder can take you by surprise and leave you feeling vulnerable. Menopause incontinence can include leaking a little urine or completely emptying your bladder before you have got to the loo. You might also feel the need to go more frequently (day or night) or find it difficult to fully empty your bladder. You may feel embarrassed or ashamed but leaking pee is common for millions of midlife women. But this is not normal and you do not have to put up with it.


Urinary incontinence (UI) is the medical name for loss of bladder control or involuntary urinary leakage. It means that you pee unintentionally – how and when this happens depends on what type of urinary incontinence you have.

Stress incontinence – Pee leaks when your bladder is under pressure, such as when you cough, laugh, exercise or lift something heavy. You might experience a small leak or complete loss of control.

Urge/urgency incontinence – Also known as an overactive bladder, this is when pee leaks when you feel a sudden, often intense urge to pee. You may also feel a constant urge to pee, even when your bladder is empty.

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  • It affects 30-40% of middle-aged/menopausal women, rising to 50% for postmenopausal women
  • Women who have been pregnant are more likely to suffer from this than those who have not
  • Your weight, alcohol and caffeine consumption and being on certain medications can also increase risk of suffering from urinary incontinence
  • Having a urinary tract infection can also cause temporary urinary incontinence

Read more about the stages of menopause.


Sudden urge for the loo with little or no warning signals

Leaking or loss of control when you cough, laugh, sneeze or lift something heavy

Constant urge to pee even if your bladder is empty, even during the night


You may experience other menopause symptoms alongside incontinence, including vaginal prolapse or anxiety. There are short-term fixes but these aren’t sustainable long-term – we recommend talking to your doctor:

1 Do your research. If you are going out, make sure you know in advance where the nearest toilets are. Always make sure you have some change for the loo handy.

2 Research pads. You can buy from a supermarket super absorbent pads and knickers to manage leaks or to help you when exercising. Underwear has improved hugely in terms of style and function – you can find plenty of companies online that make attractive knickers that are also absorbent.

3. Protect your bed. Online you can buy mattress protectors and washable or disposable absorbent sheets. There are also hand-held urinals available and devices that can be placed into the vagina or urethra to prevent urine leakage.


Strengthen your pelvic floor

Doing daily pelvic floor exercises can really help improve menopause leaky bladder. Download Stella for a personalised pelvic floor plan.

Train your bladder

Plan your trips to the bathroom during the day to gradually increase the amount your bladder can hold.

Adjust your lifestyle

Limit caffeine and alcohol as they are diuretics, making you pee more. Drink the recommended amount of water and not too much.

Losing weight reduces the pressure on your bladder and pelvic floor region. Read more about why the fun police is on about your menopausal lifestyle.

Talk to your doctor about medication

Some women are suffering so much from urgency, going to the toilet many times and are uncomfortable with the feeling of always needing to pee. Thankfully there are medications – typically, antimuscarinic drugs, which are bladder relaxants. These can provide some relief and help support you while doing pelvic floor strengthening and bladder training. 


Your GP may refer you to an urogynaecologist to discuss possible surgical options:

  • Botulinum Toxin A injections: Botox is injected into the walls (muscle) of your bladder, and acts to paralyse the muscle so it is less overactive. The effects can last several months and you can have repeat injections if needed. 
  • Sacral nerve stimulation / posterior tibial nerve stimulation: The bladder muscle is controlled by passing an electrical current through the nerves that control the bladder.

If you still suffer terribly from urge incontinence and the above treatments have not worked, there are some other procedures available. However, these are far less common, as most people do improve with the options above.


For stress incontinence, the main treatment is activating and strengthening your pelvic floor. Typically you would do this with a women’s health physiotherapist. If you are still suffering, you may be referred to a urogynaecologist to discuss surgical procedures which may help:

  • Colposuspension: The neck of the bladder is lifted up and sewn into its new position, preventing leakage long-term. 
  • Sling surgery: A sling made from human or animal tissue is placed around the neck of your bladder to support it.
  • Urethral bulking agents: This is injected into your urethra’s walls to increase size and allow the urethra to close with more force.


As we age, we lose strength in our muscles and in addition decreasing oestrogen worsens this. Also, women commonly do not do pelvic floor exercises to maintain strength.

Therefore the weakened pelvic floor and irritated bladder can lead to urinary incontinence.

If left unchecked, urinary incontinence can increase your risks of feeling low, loss of self-esteem and interfere with intimate relationships.

It can also lead to more frequent urinary tract infections.

Many types of urinary incontinence are temporary or improve with pelvic floor muscle programme.

It’s a good idea to have a chat with your doctor to see what types of medical and surgical treatment could be available to you.

The fear of going somewhere new where you do not know where the loos are can be overwhelming”



Is it normal to leak and pee a lot during menopause? Read more

Our complete guide to urinary tract infections (UTIs) during menopause. Read more

How to stem the flow of heavy periods. Read more

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