Do you ever wonder why it seems you only experience leakage at certain times of the month? Or maybe you never had any issues before and now you’re randomly leaking as you transition into menopause? You’re not alone. In fact, for many women, hormonal changes can trigger incontinence and changes to the pelvic floor muscles. While incontinence with menopause and leaking during your period is common, it doesn’t mean that this is normal.
Hormone Changes and the Pelvic Floor
A drop in estrogen levels is one the main contributors when it comes to hormonal incontinence. Women often notice changes occurring with their pelvic floor when hormone levels start to decrease. This decrease in hormone levels leads to the weakening of the pelvic floor muscles. As a result, the pelvic floor muscles can no longer contract and function like they used to. There are two times women most commonly experience a decline in estrogen: menopause and just prior to the start of menstruation.
This estrogen drop can lead to two major complaints for women: pelvic floor weakness (aka muscle atrophy) and vaginal dryness.
Pelvic Floor Weakness
One of the main functions of the pelvic floor muscles is bladder control. If the pelvic floor muscles become weak, this can lead to leaking urine. Sometimes doing kegels can help this issue. However, kegels are not always the answer to all incontinence problems. In fact, kegels actually make pelvic floor issues worse for some women. If you have tried kegels and your leakage continues, a pelvic floor physical therapist can help you determine the root of the issue.
Dryness is another pesky side effect of falling estrogen levels. Decreased estrogen levels cause more dryness of the vaginal tissue as well as the inside of the urethra. Because of this, the urethra becomes less lubricated and more “open” so it is easier for urine to leak out. This also makes the area more susceptible to infection.
Urethral dryness is most common during the transition into menopause. And even though estrogen levels won’t necessarily increase in the body, this doesn’t mean your incontinence with menopause is a lost cause. There are still other ways we can address leaking with physical therapy. Check out our podcast episode all about changing hormones with menopause to learn more.
Incontinence with Menopause
In addition to muscles weakness and dryness, lower estrogen levels during menopause can also lead to tissue atrophy. This means that the superficial (or outermost) tissues of your lady parts become fragile, weak and more sensitive. These superficial muscles are the last layer of defense against incontinence.
All of these changes occur simultaneously and are often why incontinence occurs “out of the blue” for women who have never had issues before.
For tips on how to resolve your incontinence check out our free download, "7 Easy Steps to End Incontinence."