• Menopause
• Women's Health

Can You Treat Urinary Incontinence After Menopause?

Medically reviewed and edited by Lauren Cramer, PA- C

Published: September 17, 2025
Updated: December 03, 2025
4 mins

Around and after menopause, pelvic floor muscles and tissues can weaken over time. This can be due to a combination of factors, including lower estrogen levels, aging, childbirth history, metabolic changes, sarcopenia and overall health. Urinary incontinence is more common in postmenopausal women, but it can occur at any age and is not always directly related to menopause.

Urinary incontinence is the loss of control of your bladder.  Men and women of any age may experience it, but it’s often more common in elderly individuals. Those with urinary incontinence may have to go to the bathroom more frequently or be mindful about accidental leakage throughout the day. Fortunately, there are many options for treatment regardless of what’s causing your incontinence.

What Causes Urinary Incontinence After Menopause?

After menopause, lower estrogen levels are a key contributor to urinary incontinence because they weaken the urethral lining, pelvic tissues, and bladder support. However, incontinence is usually multifactorial – age-related changes, childbirth history, pelvic floor strength, weight, medications, and neurologic or urinary conditions can all play important roles as well.

The following health conditions may increase your risk of urinary incontinence:

• Overactive bladder: Bladder muscles contract even when there may be only a small amount of urine present.

• Pelvic organ prolapse: After giving birth, stress on the body can cause pelvic organs to drop down into the vagina. 

What are the Different Types of Urinary Incontinence?

Urinary incontinence symptoms may vary depending on the type of urinary incontinence you have. A healthcare provider may diagnose you with one of the following types of urinary incontinence:

• Stress urinary incontinence: This type of incontinence occurs when the smallest physical movements can cause urine leakage. For example, laughing a lot, coughing, or being unexpectedly shoved may put pressure on the bladder.

• Urge incontinence: Also known as overactive bladder, it’s the constant feeling of having to go to the bathroom even if you don’t actually have to go. Neurological conditions like multiple sclerosis and stroke can increase your risk of urge incontinence.

• Mixed urinary incontinence: Women may experience a combination of both stress and urge incontinence symptoms. Men who have had their prostate removed may experience mixed urinary incontinence.

• Overflow urinary incontinence: Those with damage to the bladder may experience overflow urinary incontinence. It often occurs from a blockage to urine flow. With overflow urinary incontinence, there is a risk of the bladder distending (overfilling).

Who is Most at Risk for Postmenopausal Urinary Incontinence?

Elderly women over the age of 60 are more at risk of developing urinary incontinence than men and younger women. After menopause, pelvic muscles may weaken over time. While it’s rare, some women may experience urinary incontinence in their 40s and 50s.

Women have a shorter urethra than men, which may make them more likely to experience urinary incontinence. Any damage to the female urethra is more likely to cause urinary incontinence than slight damage to the male urethra.

Tips for Preventing Urinary Incontinence After Menopause

Before prescribing medication, your healthcare provider may recommend lifestyle strategies to help manage urinary incontinence. One common approach is bladder training, which involves using the bathroom on a regular schedule and gradually lengthening the time between trips. This can help reduce urgency and leakage over time and, in some cases, improve nighttime symptoms.

Pelvic floor exercises can also strengthen the muscles that support the bladder and urethra. Kegel exercises (repeatedly tightening and relaxing these muscles) may help reduce urine leakage, especially with coughing, sneezing, or exercise. However, if you feel pain or worsening symptoms while doing Kegels, stop and talk with your healthcare provider or a pelvic floor physical therapist. In some people – particularly those with an overactive or very tight pelvic floor – traditional Kegel exercises may not be appropriate and can make symptoms worse.

Consider the following additional tips to manage urinary incontinence:

• Eat a diet rich in fiber

• Reduce your alcohol intake

• Consume less caffeine

• Maintain a healthy weight

• Stay consistent with medications

How to Treat Urinary Incontinence After Menopause

If lifestyle changes don’t improve your symptoms, a healthcare provider may recommend additional treatments, such as pelvic floor physical therapy, vaginal estrogen, medications, devices, or procedures. The good news is that urinary incontinence during perimenopause and postmenopause is often very treatable, and many women see major improvement – and sometimes complete resolution – with the right care

A healthcare provider may prescribe the following medications to help relax the bladder:

• Beta-3 agonists

• Anticholinergics

• Tricyclic antidepressants

• Botulinum toxin A (Botox)

• Alpha blockers

Hormone replacement therapy (HRT) can help improve estrogen levels in postmenopausal women. You can receive systemic estrogen through a patch, gel, cream, vaginal ring, or oral tablet. Local vaginal therapies are most commonly available with estradiol tablets or creams. Increasing estrogen levels may help strengthen pelvic muscles. HRT can also relieve other menopausal symptoms like vaginal dryness and mood swings. 

However, HRT may not be the best method of treatment for everyone. Reach out to a licensed healthcare provider about how HRT may work for you based on your personal health profile.

For those with overflow incontinence, a healthcare provider may use a catheter to help you empty your bladder. Postmenopausal women may use a pessary (soft plastic vaginal device) to prevent urine leakage by supporting the urethra. A healthcare provider may recommend getting surgery if no other methods work.

How to Talk to a Healthcare Provider About Urinary Incontinence

Urinary incontinence is not the easiest topic to bring up with anyone, including your healthcare provider. However, there’s no reason to feel embarrassed. More people are managing urinary incontinence every day than you may realize. The sooner you see a healthcare provider, the faster you can receive the support you need to improve your daily life.

Before your appointment, write down how often you need to use the restroom, any recent dietary changes, and other symptoms you may be experiencing. This way, you can give your healthcare provider as much information as possible about the treatment you need.

Where Can I Learn More About Menopausal Care?

LifeMD provides resources for pre- and postmenopausal women to live fully while managing menopause. The LifeMD Women’s Health Program offers quality testing and lab options for menopause and other women’s health concerns. With LifeMD, you can receive medical guidance from licensed healthcare professionals and prescriptions for hormone replacement therapy, if you qualify.

Get started today to learn more about how you can improve your symptoms.

Lauren Cramer, PA- C

Lauren is a passionate and dedicated board-certified physician assistant. She received her Bachelor’s degree in Kinesiology and Exercise Science from SUNY Cortland — graduating magna cum laude while competing as a three-sport collegiate athlete in indoor and outdoor track and cross country. She went on to complete her Master’s degree in Biological Sciences and earn her Physician Assistant degree from Daemen College in Buffalo, New York. Lauren has years of focused experience in perimenopause, menopause, and postmenopause care, specializing in hormone replacement therapy (HRT), bone health optimization, and a functional medicine approach to women’s wellness. She integrates evidence-based hormone therapy with lifestyle, nutrition, and metabolic strategies to support long-term vitality, cognitive health, and bone density. In addition to her women’s health expertise, Lauren has a well-rounded background in allergy, asthma, otology, laryngology, and rhinology. Functional medicine has always been a passion of hers, and she continues to pursue advanced certification to deepen her ability to deliver personalized, root-cause care to her patients.

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