Managing menopause: Incontinence

Feb 10, 2010 at 11:00 a.m. ET

After having a child, your pelvic floor is never quite the same. The first time you laughed hard or coughed and your underwear was suddenly a little more damp than moments before may have taken you by surprise and you may have felt embarrassed - even though no one else could have known what just happened. You are not the only woman to have experienced this kind of "accident." Many women have been there - and many have learned to cross their legs and squeeze just a little before letting out a sneeze. Incontinence is a common issue - and it can get worse during perimenopause and menopause.

Woman crossing legsThat squeeze of urine is not an "accident" in the sense you might have used it with your toddler. It turns out that estrogen also helps keep the bladder and urethra healthy, so a drop in estrogen during perimenopause and menopause affects the bladder as well. In fact, 40% of women dealing with menopause also suffer from incontinence. It's not just that you've experienced pregnancy; there's are other factors at work. In addition, there is more than one type of incontinence.

Stress incontinence or urge incontinence

Stress incontinence is when pressure in your body from sneezing, coughing, vigorous laughing or lifting can push a little urine out the bladder. Urge incontinence is when the muscles of the bladder squeeze at the wrong time altogether. Sometimes, in addition, urinating is painful, or you have to get out of bed very frequently to urinate.

If you are experiencing any of these types of bladder issues, it can be easy to just try to handle them quietly. As much as we talk about so many previously taboo subjects, incontinence still seems to be one of those quiet, don't mention it topics. It shouldn't be, though. It's very common! And you likely didn't do anything intentional to cause it!

Get more tips on understanding urinary incontinence here.

Do your kegels!

Likely the first thing you'll do when you experience bladder issues is up the Kegel exercise. This squeezing and holding of the pelvic floor muscles is a good way to strengthen them. Just remember to keep it up! Doing Kegels for a couple weeks is good and may help the immediate issue; doing them consistently and for a longer term can help you for the long term. You could even put a reminder in your phone so a message pops up every day, reminding you.

Get more tips on taking back control of your bladder here.

Consult your doctor

As embarrassed as you may be, your doctor has seen the issue before and can help you. If simply upping the Kegels isn't enough, your doctor may be able to help you identify other issues contributing to the problem, then help devise exercise, diet and lifestyle modifications. In some cases, medication is appropriate - and can be a relief from the constant worry.

For more tips on managing the symptoms of menopause and perimenopause: