One part of your body that probably isn’t slowing down as you approach menopause is your bladder. You may be noticing an increase in the number of times you have to pee each day, and many of those trips to the bathroom may be pretty urgent. Unfortunately, overactive bladder and urinary incontinence increase as you get older. According to new research published in Menopause, the journal of The North American Menopause Society (NAMS), about one in five women ages 50 to 54 experience these unpleasant conditions. The study included more than 12,000 women, ages 27 to 82.

An overactive bladder generally refers to an urgent and frequent need to urinate. When you experience urine leakage before you can get to the bathroom, that is urge incontinence. The more common type of incontinence is stress incontinence which occurs due to physical pressure. It’s when you leak a little (or a lot) of urine when you laugh, sneeze, or cough, or when you’re exercising or having sex.

What causes bladder problems in midlife and menopause?

Estrogen affects just about every system in your body, including your urinary system. With less estrogen, your bladder that holds urine and your urethra, the tube that carries urine out of your body, weaken, which affects your ability to control your urinary function. Your bladder also loses volume and elasticity as you age which can contribute to problems.

Other contributors to bladder problems may include:

  • Weight gain, a common side effect of menopause, is a risk factor for stress incontinence because the extra weight puts pressure on your bladder.
  • Medications like antidepressants may affect urinary control.
  • Conditions such as diabetes and multiple sclerosis can cause nerve damage that affects bladder control.

How to curb the urge and stop leaks

Since bladder problems can be embarrassing, impact your lifestyle, and worsen with age, the sooner you take action the more relaxed and happier you’ll be. Here are six ways to minimize bathroom visits and leakage.

Drink up. It may seem counterintuitive, but your urinary system—along with the rest of your body—functions best when it’s well hydrated. Restricting fluids cause urine to become very concentrated, which irritates the bladder. It also conditions your bladder to hold smaller amounts of urine, meaning more potty breaks throughout the day. Instead, aim to drink about half of your body weight in ounces a day. If you’re not getting enough fluids, gradually increase the amount you’re drinking by sipping small quantities throughout the day. Dehydration can worsen other menopause symptoms, too, so as you rehydrate you may notice other improvements. If you’re drinking excessive amounts of fluid, you may need to cut back on your intake.

Exercise your pelvic floor. Your pelvic floor is a sling of muscles that stretch from your pubic bone to your tail bone and out to the sides to support your bladder, intestines, and uterus. These muscles are responsible for controlling urination, but hormone changes during menopause can weaken them. Other contributing factors include childbirth, surgery, persistent coughing, and chronic constipation. To strengthen your pelvic floor muscles and regain more control of your bladder, perform Kegel exercises by contracting and releasing the muscles around your vagina and anus. Imagine that you’re trying to stop the flow of urine or trying to avoid passing gas. Aim to do three sets of 10 Kegels daily. If you’re unsure if you’re doing Kegels right, a physical therapist specializing in pelvic health can help. There are also devices like elvie kegels that provide feedback to assist you in engaging the correct muscles in the right way.

Avoid diuretics. Caffeinated beverages like coffee, tea, and soda act like diuretics, increasing urine production, so you must pee more frequently. Caffeine also irritates the bladder, which results in contractions that will send you to the bathroom, typically within five to 45 minutes of consuming caffeinated beverages. Cut back or eliminate these beverages from your diet.

Watch out for other bladder irritants. In addition to caffeine, other beverages and foods that can aggravate urinary problems include alcohol, carbonated drinks, artificial sweeteners, citrus, tomatoes, tomato-based dishes, and spicy foods. Try eliminating these irritants and see if your symptoms improve. Not all foods affect everyone, so you can try reintroducing foods one at a time to see which ones affect you the most.

Get more fiber. Too little fiber in your diet can cause constipation, which puts more pressure on your bladder. Aim to get about 25 grams of fiber a day by eating more vegetables, beans, and fruits. Some good sources include oatmeal, oat cereals, barley, beans, nuts, lentils, peas, apples, blueberries, oranges, Brussel sprouts, and sweet potatoes. Fiber also helps by filling you up with fewer calories to make it easier to keep your weight under control.

Schedule bathroom visits. Start by going every two hours whether or not you have to go. This regularity can help prevent sudden urges. Once you see improvement, gradually increase the amount of time between bathroom visits. This will retrain your bladder to hold more urine.

When to see a doctor about overactive bladder concerns

If frequent urination or leaks are interrupting your life, talk to your doctor. There are medications, hormones, biofeedback, devices, and as a last resort, surgery that can help. Physical therapists who specialize in pelvic floor issues can help you to strengthen pelvic floor muscles and retrain your bladder.

If you’re taking medications like antidepressants or have other health problems like diabetes, your doctor can help determine if any of these factors are contributing to your bladder issues.

You’ll also want to see a doctor if you have any of these symptoms:

  • A change in the color of your urine, such as red, pink, or brown
  • Having trouble emptying the bladder completely
  • Pain or burning when urinating
  • Fever

It could be the sign of an infection or something more serious.

We can help you manage overactive bladder and incontinence

  • Meet with a Gennev Doctor -Our board-certified physicians are menopause specialists and can help you narrow down the possible causes of your symptoms and discuss next steps for full evaluation and management.
  • Vitality is a proven, daily nutrient-packed supplement for women in menopause, that supports mood, energy, stress response, immune health, joint pain, and inflammation


The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy. 



Michele Stanten

January 27, 2022

Medically Reviewed By

Dr. Lisa Savage

Board-Certified Obstetrician & Gynecologist

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