By Dr. Anna Garrett for LiveConfidently.com

If you’re a woman who’s entered perimenopause, you may be noticing that trips to the bathroom are becoming more frequent and less in your control. This can be annoying and embarrassing, especially if you don’t make it quite in time!

What’s the connection between menopause and “gotta go right now”?

During perimenopause and menopause, the level of estrogen, which helps to keep the tissues of your bladder and urethra healthy, begins to drop significantly. If you’ve begun to notice dryness and sensitivity during sex, this may be a clue that you’re at risk for bladder problems as well. Just as the tissues of the vaginal wall begin to thin and dry out, so does the tissue that lines the bladder. When that happens, your bladder becomes more sensitive to irritants, which can make you more susceptible to light bladder leakage.

Lack of estrogen can also cause the pelvic muscles, which are responsible for maintaining bladder control, to weaken, eventually resulting in incontinence. Women who have had hysterectomies may experience these issues to an even greater extent because the surgery itself will affect pelvic floor muscles.

What kinds of bladder control problems can happen with menopause?

Bladder problems during menopause can take several forms:

• Urge Incontinence: When you have to go, you have to go now.
• Overactive Bladder: You have to go all the time, and defined as a problem if you need to go more than eight times in a 24-hour period. This is especially problematic if you have pre-existing issues like insomnia.
• Stress Incontinence: That good hard laugh or unexpected sneeze can result in an unwelcomed wetness just when you least expect it.

The good news is that there are ways to lessen the impact of roller-coaster hormones. The data on hormone replacement therapy is not conclusive, but some women feel like they have more control after starting hormones. Dietary changes and pelvic floor exercises (Kegels) may also be helpful.

Do you have any comments or questions about hormone levels and incontinence? Visit our incontinence and menopause forum thread to discuss this with people just like you!