It turns out our hormones are more extra than we thought. Surprise! Not only do they affect your mood, but they also have a hold on your bladder health throughout the menstrual cycle. They can even cause what’s known as cyclical incontinence, no matter your age.
Aleece Fosnight, a urologist and medical advisor at Aeroflow Urology, is here to educate us on the link. “Hormones play a significant role in maintaining the health and function of the bladder and urethra. Fluctuations in hormone levels can affect various aspects of bladder function, including bladder muscle tone, pelvic floor structures, nerve function, and urinary incontinence,” Fosnight explains.
She says cyclical incontinence, which occurs during specific times during the menstrual cycle or other hormonal shifts, is common. Although “symptoms depend on the underlying cause of the cyclical incontinence, they include urinary incontinence before, during, or after a specific trigger,” such as:
- Incontinence around menstruation.
- Lactation menopause or bowel conditions such as IBS/constipation.
- Urinary symptoms: frequency, urgency, stress incontinence, urge incontinence, mixed incontinence, nocturia, and nocturnal enuresis.
Thankfully, not treating cyclical incontinence will not lead to any serious complications, but Fosnight warns that underlying conditions can. “Physical concerns can include skin irritation, urinary tract infection, dysfunctional voiding, pelvic floor dysfunction, and incomplete bladder emptying.”
Below, Fosnight breaks down the phases of the menstrual cycle and gives tips to manage cyclical incontinence (so Aunt Flo doesn’t have to ruin your flow).
Fosnight explains that this phase sees an increase in urine volume and a decrease in progesterone. “Some menstrual products such as tampons and menstrual cups may cause added pressure to the bladder with use.” To combat this, she recommends “increasing water intake, avoiding bladder triggers, and moving your body to help release extra fluid retention.” Also, remember to change tampons/menstrual cups frequently, or take breaks as needed if associated with urinary incontinence.
Follicular Phase (Days 6-14)
Luckily, Fosnight says, “Less urinary incontinence occurs during this phase.” She suggests using this time to work on strengthening the pelvic floor muscles with a therapist or by using exercises and stretches. Also, continue to hydrate, avoid constipation, and move your body to engage core muscles.
“[A] surge of estrogen just prior to ovulation could cause some incontinence. However, there has not been clear evidence that supports this. And, if anything, estrogen is a bladder-supporting hormone that causes lower levels of incontinence,” Fosnight says.
She has “minimal recommendations as this is a very short window.”
Luteal Phase (Days 15-28)
“This is where we see the most urinary incontinence, secondary to progesterone,” Fosnight explains. “There have been several studies that show progesterone directly impacts the detrusor muscle, causing it to contract more frequently, and leading to more urinary incontinence opportunities.” She says that anticipating possible incontinence can be helpful (along with psychoeducation on the pathophysiology) in addition to implementing all her advice from the other phases.
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