We are all born with a pre-programmed ageing process and it is already determined at birth when it is time for menopause (last period). The years before and after the last period are called the menopause. During perimenopause and menopause, the hormone oestrogen drops in the body. It is the ovaries that stop producing oestrogen, so no follicles mature (and no corpus luteum) and there can be no ovulation and therefore no period - menopause!
The actual mechanism for continence, i.e. actively holding urine, is the muscles and ligaments in the pelvic floor that pull the vagina close to the urethra, thus closing the urethra, while the bladder is pulled downwards and backwards like an elastic balloon, which bends and closes the centre of the urethra. The mucous membrane in the urethra helps to seal the closure.
Incontinence in menopause
The ligaments of the pelvic floor must be able to stretch and relax when a woman gives birth, but they should return to their normal state after labour. Unfortunately, they are sometimes 'glued' together in their stretched and loosened state. The same can happen during menopause when collagen and elastin break down and the muscles and ligaments of the pelvic floor become stretched and stiff and you may find it difficult to keep it tight. This is why it is common to experience incontinence as you get older.
Read more about menopause here.
Urine leakage due to dry mucous membranes
Declining oestrogen also affects mucous membranes in different parts of the body. For example, you may experience dry eyes or dry and fragile mucous membranes in the vagina. The fragile mucous membranes in the vagina are also found on the inside of the urethra, and sometimes it can hurt when you urinate. Some women also get repeated urinary tract infections with or without bladder leaks.
Bladder dysfunction and urinary incontinence mainly affect older people, both men and women. Sometimes it is simply a case of the body getting older, but in many cases there may be an underlying disease or disability. Whatever the age or size of the problem, you should always seek help if it prevents you from living your life as you wish. You can read more about how to seek help here.