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    Low estrogen levels during menopause can cause many different symptoms and health concerns. As you may know, declining estrogen is responsible for symptoms like hot flashes and mood changes during menopause. However, many people don’t realize that low estrogen during menopause can also lead to other issues like overactive bladder. Let’s discuss the link between estrogen and overactive bladder (OAB) and what you can do to help with OAB during menopause.

    woman doing yoga after treating overactive bladder from low estrogen

    Low estrogen might cause changes in your pelvic muscles and bladder that affect your everyday activities.

    Low Estrogen During Menopause Can Lead to Overactive Bladder

    Many people experience overactive bladder. However, overactive bladder is more common in women, and the risk for OAB increases as we approach middle age. This is also the time where our hormone levels begin to fluctuate, eventually leading to menopause.

    Studies suggest decreasing estrogen levels in menopause may be to blame for overactive bladder and urinary incontinence. Estrogen is an important hormone in your body that is responsible for many different functions. You can find estrogen receptors throughout the body, including in the bladder. Therefore, changes in estrogen levels during and after menopause may lead to overactive bladder symptoms.

    What is Overactive Bladder?

    Overactive bladder is a health condition an estimated 33 million Americans experience. This condition affects your bladder control and can cause unwanted symptoms that affect everyday life. Overactive bladder is a type of urinary incontinence and is also known as urgency incontinence. OAB is different from stress incontinence, which can cause you to leak urine when there’s extra pressure on your bladder, such as when you cough, sneeze, or laugh. Instead, overactive bladder generally means you experience frequent and urgent feeling that you need to pee, often at inconvenient times.

    Symptoms of Overactive Bladder

    Overactive bladder can cause many symptoms. You might have overactive bladder if you:

    • Experience sudden urges to urinate immediately
    • Can’t “hold it” until you can make it to the toilet
    • Experience urine leaks right after a sudden urge to urinate
    • Wake up at night frequently to pee
    • Urinate more than eight times in a 24-hour day

    As you can see, overactive bladder can be a disruptive condition that may affect your overall quality of life. Fortunately, there are treatments available.

    It’s important to understand that overactive bladder is not a normal part of aging. Our providers can help you find treatment solutions based on your needs and lifestyle, including increasing estrogen levels in your body if low estrogen is to blame for your OAB.

    How Does Low Estrogen Lead to Overactive Bladder?

    The link between overactive bladder and estrogen is complex. Researchers are still studying the exact cause. However, there are several potential explanations that may shed light on estrogen’s effects on the bladder.

    Low estrogen can cause many changes in the body, including weaker pelvic muscles and a thinner urethra lining. These changes may increase the risk for overactive bladder and poor bladder control after menopause.

    Low Estrogen Weakens the Pelvic Muscles

    The higher estrogen levels we have in our bodies before menopause may have a protective effect on the pelvic muscles. Estrogen can help keep the pelvic muscles strong before menopause. Strong pelvic muscles support the bladder and also assist with the ability to hold in your urine until you can make it to the bathroom.

    Low estrogen during and after menopause can cause pelvic muscles to become weaker, reducing bladder support and your ability to hold in your urine. In turn, this can cause overactive bladder symptoms, like frequent and strong urges to urinate or not being able to make it to the restroom in time.

    Low Estrogen May Thin the Lining of the Urethra

    Declining estrogen levels during menopause can also affect the lining of your urethra, which is the tube that connects your bladder to the outside of the body. The lining of the urethra is made up of muscle tissue that allows it to contract and expand. When you use the restroom, the lining relaxes while the bladder contracts to let the urine out of your bladder and into the toilet.

    However, low estrogen can cause this lining to become thinner and less elastic. This may also explain the connection between menopause and overactive bladder, as a thinner lining may make it more difficult to prevent urine leaks when you experience the urge to urinate.

    Other Explanations for the Link Between Estrogen Levels and Overactive Bladder

    There may also be other explanations for why low estrogen levels can increase the risk of overactive bladder. For instance, lower estrogen during menopause can lead to more frequent urinary tract infections, which is where a bacteria builds up in the urinary tract and causes an infection. UTIs can also cause inflammation and irritation throughout the urinary tract and bladder, which may cause some of the same symptoms as overactive bladder like frequency, urgency, and incontinence. However, without treatment, UTIs can lead to issues like permanent kidney damage or even sepsis. Therefore, your symptoms of OAB could actually be an infection that may turn life-threatening if left untreated. If you’re experiencing symptoms of overactive bladder, it’s important to seek help from one of our providers to rule out a UTI and get treatment.

    Another potential reason many women experience overactive bladder after menopause is due to increased pressure on the bladder. It’s common for women to gain weight around the time of menopause. Those extra pounds can also put added stress on the bladder and make it harder to control urges to urinate or hold in your urine until you can reach the restroom. Therefore, menopausal weight gain could also be part of the problem when it comes to overactive bladder.

    Women’s Hormone Care May Help with Overactive Bladder

    Because of the association between estrogen levels and overactive bladder, many researchers have been studying the effects of hormone therapy on overactive bladder. One 2020 study published in the American Journal of Obstetrics & Gynecology found that vaginal estrogen may help relieve overactive bladder symptoms. The researchers believe this is due to a type of good bacteria called Lactobacillus.

    Lactobacillus is a type of bacteria found in the gut, vagina, and also in the bladder. Yet, low estrogen levels can reduce the amount of this good bacteria in your body. The study looked at the number of Lactobacillus bacteria in the bladder for women using estrogen replacement therapy. They found that those using vaginal estrogen had more of the bacteria in their bladder and also saw some improvements in their overactive bladder symptoms.

    Therefore, women’s hormone care may help with your overactive bladder symptoms. For example, it’s common to use vaginal estrogen to help strengthen the muscles and tissues in the pelvic area and urethra, which may work well for your overactive bladder.

    Other Treatments for Overactive Bladder

    There are also many other treatment options available for overactive bladder which may work well for you. When you discuss your symptoms with our team, we may recommend some of these treatments to help you improve bladder control and symptoms.

    For example, our providers may recommend lifestyle changes, such as maintaining a healthy weight to reduce the pressure on the bladder. We may also recommend Kegel exercises, which can strengthen the pelvic muscles. Also, scheduled bathroom breaks, even if you don’t feel the urge to go, can help retrain your bladder to prevent those strong and sudden urges to urinate.

    Other treatment options include medications. Typically, the medications are designed to relax the bladder to help with the symptoms of urgency. These often come in pills or patches you use each day. However, some people also receive small doses of Botox in the bladder to help relax the muscles. Our providers can discuss personalized treatment options for you.

    Healthcare for Women at HerKare

    Our team at HerKare is dedicated to providing quality healthcare for women. We are a clinic owned and managed by women and are here to help you improve your health. Whether you need a hormone doctor for your menopause symptoms or need preventative well woman care, our providers listen, understand, and help you take care of your overall wellbeing. Make an appointment today at one of our convenient locations.