The years leading up to menopause are the start of when many women start to notice bladder leaks.

According to the Mayo Clinic, Menopause is a natural decline in reproductive hormones when a woman reaches her 40s and 50s. Menopause is signaled 12 months after the last menstruation.

Although there are several reproductive hormones, one hormone that helps us maintain our muscle strength is estrogen.  During peri-menopause and menopause, the levels of estrogen begin slowly to decrease. There is a direct correlation between this decrease in estrogen levels and the decrease in muscle strength throughout.

During your 40s and beyond, you may notice that building and maintaining muscle mass or strength becomes more difficult.  It can be done, but it will take more effort and consistency.

The decrease in estrogen levels starts in the peri-menopause years. Peri-menopause can start in your early forties, with the average age for the menopause transition for women in the US at 52-54 years.


What happens to the Pelvic Floor during this time, and how can this be related to bladder leaks?

The decrease in estrogen affects Pelvic Floor muscles just as it does with all other muscles throughout the body. Even with a small amount of muscle weakening, it can become harder to control and stop leaks.

The Urethra is the tube from the bladder that empties to the outside. During this time the walls of the tube begin to thin. This can interfere with the regular flow of urine, making it more difficult to urinate freely or maintain bladder control.


What can you do?

The first step is to find out what might be causing your leak.  Many times it is a combination of factors. Many times pelvic strengthening will help tremendously.  Other times, different strategies in combination with strengthening may be needed to stop your leaks.

Finding the right health professional can ensure you progress quickly to stop your bladder leak. Having guidance to put together the right plan can make the chances greater that your bladder leak improves.

Once you find the right person, your program can include:

  • Pelvic floor strengthening
  • Bladder training
  • Core and hip strengthening

A long list of other interventions can be tailored to your symptoms. When the program and exercises are targeted to your needs, you have the best chance to stop those leaks safely and quicker.



Shelia Craig Whiteman

Shelia Craig Whiteman

Dr. Shelia Craig Whiteman DPT, CLT is a doctor of physical therapy and a health coach. While practicing physical therapy, she specialized in pelvic health, lymphedema, and oncology. As a health coach, Dr. Shelia is particularly passionate about helping women to reduce and stop bladder leaks.

She is the best-selling author of “To Pee or Not To Pee?” The Guide for Reducing and Eliminating Urinary Incontinence. Her second book, Stop Worrying About Bladder Leaks, further explains how and why bladder leaks can happen. As an advocate for health and wellness, she participates in several educational presentations and volunteer activities in her community.

Dr. Shelia is a certified fitness instructor and has taught fitness and pilates classes over the past 20 years. She lives with her family in Mitchellville, Maryland.

Watch Dr. Shelia’s video on Bladder Leaks here: