Why Bladder Health Matters During Menopause — And What You Should Know
When most people think of menopause, they think of hot flashes, insomnia, and mood swings. But there’s one topic that often gets left out of the menopause conversation, and it’s time we gave it the attention it deserves: bladder and urinary tract health.
A new study published in Menopause, the journal of The Menopause Society, sheds light on how menopause — and the use of hormones — can impact bladder health in ways that many women aren’t prepared for.
Although menopause is known to bring changes like vaginal dryness and painful intercourse (grouped under what’s called genitourinary syndrome of menopause), far less attention has been paid to how it affects the bladder and urinary tract.
The new research, part of the RISE FOR HEALTH study, surveyed more than 3,000 women across premenopausal, perimenopausal, and postmenopausal stages of life. The findings were clear — bladder health tends to decline with age, and this decline is more pronounced for women going through or past menopause.
Some key takeaways:
Bladder health worsens during perimenopause and postmenopause compared to premenopause.
Hormone therapy use is linked to worse bladder health in postmenopausal women.
Systemic hormone therapy (hormones that travel through the entire body) is associated with a greater risk of urinary incontinence.
In contrast, localized, low-dose hormone therapy (like vaginal estrogen) can actually improve urinary symptoms and reduce infections.
Interestingly, the study also found that premenopausal women were more likely to be using hormones than those in later stages, and their bladder health was less affected by hormone use.
Why This Matters for Midlife Women
Bladder and urinary tract symptoms can be disruptive, affecting sleep, intimacy, exercise, and overall quality of life. Yet many women are never told to watch for these changes, or they may feel embarrassed about bringing them up with their healthcare provider.
As Dr. Stephanie Faubion, medical director for The Menopause Society, explains:
"The relationship of hormone therapy with bladder health and lower urinary tract symptoms is more complex and requires a nuanced and individualized approach."
In short, it’s not one-size-fits-all, and understanding your options, including both lifestyle changes and targeted treatments, can make a real difference.
What You Can Do
The good news is that being aware of these symptoms and what you can do is empowering. This research reinforces the importance of early education around bladder health, ideally before menopause begins.
If you’re noticing changes in your urinary habits, such as increased urgency, leakage, or frequent infections, it’s worth talking to a healthcare professional trained in menopause care.
Here’s what I recommend to my clients:
Pay attention to your symptoms. Bladder issues are common and treatable.
Advocate for yourself with your healthcare providers.
Talk to your doctor (ideally one who knows menopause) about hormone options.
Strengthen your pelvic floor. A good physical therapist or app can help.
Track your patterns. A journal or app can help identify what’s triggering symptoms.
Stay hydrated. It sounds counterintuitive, but less water can actually lead to more irritation.
Increase your fiber. Constipation can make matters worse.
And most importantly, don’t be embarrassed to bring it up. You deserve to feel confident, strong, and supported, whether you’re sprinting to the bathroom or reclaiming your power one pelvic squeeze at a time.
Want to talk more about this or get support on your midlife health journey? Reach out to me here.
