Why We Need to Talk About Pee: Urinary Health in Perimenopause and Beyond
- Team Surety
- Dec 7, 2023
- 3 min read
Updated: May 25
Reviewed by Dr Nav Uppal, Community Lead & Medical Advisor of Surety [MBBch (UK), MRCGP(UK), Diploma Royal College of Obstetrics & Gynaecologist (UK)]
Many women also silently struggle with urinary health issues, often misunderstood or dismissed as part of aging.
More Than Hot Flashes
When we talk about menopause, hot flashes and fatigue usually take center stage. But many women also silently struggle with urinary health issues—often misunderstood or dismissed as part of aging. These challenges stem not just from menopause, but also from a lifetime of physiological changes, including pregnancy, childbirth, pelvic surgeries like hysterectomies, and conditions such as irritable bowel syndrome, diabetes, or neurological disorders.
Additionally, anatomical differences—like a shorter urethra—make women more vulnerable to urinary problems than men.
Living with Overactive Bladder (OAB)
Overactive Bladder (OAB) is more than just a nuisance—it’s a life-altering condition. It brings constant anxiety over sudden urges, frequent bathroom visits, and possible leaks. For many women, it affects professional focus, social confidence, and overall mental well-being.
This two-part series is designed to raise awareness and normalize the conversation around midlife urinary health:
Part 1: Understand the causes, symptoms, and physical changes behind urinary issues.
Part 2: Explore treatment options, lifestyle strategies, and available support resources
What Does a Healthy Bladder Look Like?
A healthy bladder functions with a delicate coordination of muscles. The bladder muscle (detrusor) contracts when full, while the sphincter and pelvic floor muscles control the release of urine.
Estrogen plays a vital role in maintaining the strength of these muscles. It supports tissue integrity in the urethra and vaginal area, contributing to healthy bladder function.
How Perimenopause Affects Bladder Function
During perimenopause, estrogen levels begin to decline. This reduction leads to:
Thinning of urethral and vaginal tissues
Weakened pelvic floor and sphincter muscles
Reduced elasticity and moisture in the urinary tract
These hormonal changes can contribute directly to urinary symptoms like frequency, urgency, and leakage.
Understanding Overactive Bladder (OAB)
OAB occurs when the bladder sends signals to empty—even when it's not full. This involuntary contraction leads to:
Urgency: Sudden, intense urge to urinate
Frequency: Needing to urinate more than 8 times a day
Nocturia: Waking up multiple times at night to urinate
Leakage: Involuntary urine loss, often before reaching the toilet
Though OAB can affect anyone, it is especially common among women over 40.
The Disruptive Nature of Frequency and Urgency
For women in midlife, frequent urination can interfere with productivity, rest, and peace of mind. Some report needing to urinate every 30–60 minutes—causing disruptions in meetings, travel, or sleep.
Involuntary Leakage and Its Emotional Toll
Leakage, or urinary incontinence, can occur with simple actions like coughing, laughing, or sneezing. It can lead to shame, embarrassment, and social withdrawal—but it doesn’t have to be accepted as inevitable.
When to Seek Help (And Why Many Don’t)
Too often, women normalize these symptoms, chalking them up to “just getting older.” But urinary incontinece and OAB are medical conditions—and they are treatable.
Common barriers to seeking help include:
Misconceptions that nothing can be done
Embarrassment in discussing symptoms
Fear of invasive procedures
The reality? A wide range of treatment options exists—from pelvic floor therapy and lifestyle adjustments to medications and minimally invasive interventions.
Take Charge: Tips for Better Urinary Health
Pelvic Floor Exercises (Kegels): Strengthen muscles that support the bladder
Lifestyle Adjustments: Avoid bladder irritants (caffeine, alcohol), manage weight, and stay hydrated
Bladder Training: Learn to delay urination to train your bladder for longer intervals
Medical Consultation: A urogynecologist or women's health doctor can guide diagnosis and treatment
Urinary health is a key aspect of midlife wellness that deserves attention—not silence. The sooner you recognize and address these symptoms, the sooner you can regain control and confidence.
You are not alone, and help is available.
For local directory and guide, contact us at contact@suretysg.com.
Important Notes: The content on this website is intended for informational purposes only and should not be considered medical advice. It is not a substitute for professional diagnosis or treatment. While we strive to provide accurate and up-to-date information, we make no guarantees regarding completeness or accuracy. Readers are encouraged to consult qualified healthcare professionals before making any health-related decisions. This website may include links to external sites, for which we are not responsible. Any actions taken based on the content provided are at the reader’s own risk. Some content may include affiliate or sponsored links, which do not influence our recommendations.
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