Updated 29 January 2018

Urinary incontinence in menopause

A bout of coughing or even a good laugh may lead to an embarrassing little accident - decreasing oestrogen levels can weaken muscles controlling the bladder and urethra.

Decreasing oestrogen levels can weaken the pelvic floor muscles controlling the bladder and urethra (tube through which urine is passed from the bladder) leading to a number of conditions including incontinence

The tissue of your urinary tract also becomes less elastic.

These changes can lead to painful urination (called dysuria), urination at night (called nocturia) and the need to urinate urgently (called urge incontinence).

Another symptom which may be associated with these changes is stress incontinence, which is involuntary urine leakage, occurring with coughing, laughing, sneezing, exercising or sudden exertion.

However, stress incontinence can have organic causes and is not alleviated by hormone therapy (HT). HT will only have a positive effect on symptoms stemming from bladder irritability.

Other problems that may arise are frequent bladder and vaginal infections.

Read: The different types of incontinence

What you can do

Incontinence problems can often be improved by doing exercises regularly that strengthen the pelvic muscle. These exercises are called Kegel exercises.

  • Contract the pelvic muscles as if trying to close the vaginal opening.
  • Hold the contraction for a count of three and then relax.
  • Wait a few seconds and repeat.

Fast Kegels (squeezing and relaxing muscles as quickly as possible) can also help.

Performing several Kegels per day (try for 50) can improve bladder control – and may enhance sexual pleasure.  

Reviewed and updated by Dr Alan Alperstein, obestetrician and gynaecologists in Cape Town


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Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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