Taking Control of Urinary Urgency

Bladder issues during menopause are prevalent in women. However, they are manageable, and women can regain control through a combination of tuning into their bodies, strengthening their cores, and exploring various treatment options.

There are multiple reasons why women may experience urinary urgency when entering perimenopausal and menopausal periods. Two primary reasons for a sudden urge to urinate coupled with incontinence are weakening pelvic floor muscles and the loss of vaginal tissue elasticity courtesy of the decline of estrogen. 

However, often overlooked are lowered or imbalanced estrogen hormone levels. This lack of estrogen contributes to the increased sensitivity in bladder tissues that makes a woman’s bladder become irritated and unable to fill up like a balloon wanting to eliminate sooner than what is considered normal. This is called overactive bladder (OAB), and nearly one-third of women will experience this condition.

Women are encouraged to consult their healthcare provider if they are experiencing bladder and incontinence issues. However, the National Association for Incontinence (NAFC) provides some helpful guidance to troubleshoot this issue.

Watch What You Eat and Drink. Certain foods and drinks can irritate the bladder and exacerbate symptoms such as urgency or frequency. Common culprits include caffeine (from coffee, tea, and energy drinks), alcohol, sugary foods and beverages, artificial sweeteners, spicy foods, and acidic items such as tomatoes and citrus fruits. 

Everyone’s sensitivity is a little different. So, it’s helpful to keep a food and symptom journal to identify personal triggers. 

And drink water! Aim for 64-72 ounces daily to stay hydrated and avoid concentrated urine, which can also irritate the bladder. Just space this fluid intake throughout the day to avoid nighttime urgency.

Strengthen The Pelvic Floor. Pelvic floor muscles support the bladder and other pelvic organs. When weakened, often due to aging, childbirth, or hormonal changes, they can contribute to incontinence.

Kegel exercises are a good starting point. Contract your pelvic muscles like you're stopping a stream of urine. Hold for 5–10 seconds, and then release. Repeat 10–15 times, 2–3 times daily.

Pelvic floor apps such as Kegel Trainer, are helpful. Also, consider working with a pelvic floor physical therapist for personalized guidance.

Additionally, Intimaterose.com offers a range of medical-grade pelvic floor wands and provides detailed instructions on their use. You can also consult a pelvic floor therapist for one-on-one guidance.

Consider Hormone Therapy. Estrogen levels drop during menopause, which affects bladder tissues and urethral function. Hormone Replacement Therapy (HRT) may help, but it’s not a one-size-fits-all solution.

HRT options include vaginal creams, tablets, and patches, which are ideal for localized symptoms like dryness or urinary discomfort. Women are encouraged to consult their healthcare provider about the solution that best addresses their health needs.

Explore Medication Options. If lifestyle changes aren’t enough, medications may help address overactive bladder, stress incontinence, or leakage with sneezing, coughing, exercise, as well as other menopause-related conditions like hot flashes and night sweats and vaginal dryness or discomfort.

Women entering or in the stages of menopause must begin dialogues with their healthcare provider, who can recommend the best prescription and over-the-counter options that fit their needs.

Kelly Rigo is the creative force behind Menopause Evolution.