While ageing is a fact of life for everyone, there are physical changes that are only experienced by one gender over the other. Case in point - menopause for women.

Menopause is defined as the permanent ending of ovarian function, and the end of menstruation [1].
The ‘menopausal transition’ can be broken into three stages [2]:

• Perimenopause - the time leading up to menopause
• Menopause - a period of 12 consecutive months without menstruation
• Postmenopause - the time after menopause where oestrogen levels remain low and you no longer experience menstruation

It most commonly begins between the ages of 45 and 55 - with the median age of onset being 51. The full process of menopause (all three stages) generally lasts for about seven years, but can last as long as fourteen years for some [1].

The age of onset and duration varies from person to person, as do the severity of symptoms.

In this article we look at the symptoms associated with menopause, incontinence being one of them. Keep reading to find out how menopause could impact bladder and bowel function.

Before we get into the symptoms of menopause, it’s important to understand the biological processes taking place inside the body during the menopause transition, as it’s characterised by lots of fluctuations in hormone levels and production [1].

During perimenopause, there are few mature eggs left in the ovaries which results in irregular ovulation and menstruation. This irregularity causes fluctuations in the production of female hormones oestrogen and progesterone, until an eventual decline to extremely low levels [4]. During menopause and postmenopause, your ovaries will stop making these female hormones.

Perimenopause is when a woman will experience the majority of symptoms associated with menopause due to the changes in hormone levels [5].
The symptoms can include [6,7]:

• Irregular periods
• Hot flashes and sweating
• Sleep disturbance
• Changes to mood and sex drive
• Changes in weight
• Vaginal and bladder problems - including incontinence

While incontinence may still be considered a taboo subject to so many, it’s actually a lot more common during menopause than you might expect.

Over 55% of postmenopausal women report experiencing incontinence [9], while approximately 15% of women over 40 experience faecal incontinence - a number that triples once you start going through menopause [10].

The lower levels of oestrogen during the stages of menopause can impact the bladder and excretory systems in a variety of ways [4], including:

• A reduction in bladder elasticity
  As the bladder becomes less elastic, it's unable to stretch effectively as it fills with urine. This can irritate the bladder and cause it to be 'overactive', leading to the need to urinate more frequently paireed with a sudden urge to go. It can also be more difficult to 'hold on' or put off going to the toilet [11].
  
  
• Weakening of the pelvic floor muscles
  The pelvic floor is a group of muscles and ligaments that support the bladder, uterus and bowel. The anal and urinary sphincters, which are cessary in stopping the excretion of urine or faeces, are part of the pelvic floor. The weakeninig of these muscles can therefore mean a decreased ability to 'hold on', as well as the need to go to the toilet more often. Bowel control can be worsen if you've given birth earlier in life and had damage to the anal sphincter, too [11].
  
  
• Dryness and thinning of vaginal tissue
  Also referred to as vulvovagina atrophy, the thinning and drying of vaginal tissue (including the tissue around the urethra and in the urinary tract) is extremely common during the menopause transition and in postmenopause. With this can come incontinence, as well as irritation and soreness [12].

You might experience different types of incontinence from the above factors, such as stress or urge incontinence. You might also find you're waking up during the night due to the urge to pee [9].

If you're already experiencing menopause (or are heading into that phase of your life), the first step should always be to see your doctor for tailored advice. They can also assist with prescribing any necessary medications that may help in lessening some of the symptoms of menopause.

If incontinence is a symptom you're experiencing alongside menopause, there are some things you can do at home to help manage and regain your confidence.

• Pelvic floor exercises
  Having a strong pelvic floor is essential to assisting the anal and urinary sphincters to perform properly, so performing pelvic floor exercises is a great idea to help improve bladder and bowel function and/or control.
  
  
• Lifestyle changes
  Maintaining a healthy diet, engaging in exercise and cutting down on drinks containing caffeine are all things you can do to help manage incontinence. These changes might also assist in losing excess weight which can help with incontinence by reducing stress on the bladder [11].
  
  
• Investing in quality incontinence supplies
  We have a wide range of highly-rated, quality incontinence aids available to suit your needs to help manage incontinence, from pads to pull-ups to bedding and furniture protectors.
  
  Choosing which absorbency level will best suit your needs depends on a few factors, so you can take our Help Me Choose quiz to get a better understanding. Or you can contact us to speak to our customer service team who can give more tailored product advice.
  
  Rest assured you can rely on our range of incontinence aids - whichever you use. With advanced absorption technology, active odour control and a slimline design for discreet wear underneath clothes, you can relax knowing ConfidenceClub has you covered!

Experiencing incontinence during menopause doesn't need to impact your life negatively, and with these tips above you can continue to feel comfortable living your regular day-to-day life with confidence.