The reduction in estrogen that occurs with menopause has long been associated with muscle weakening. This weakening also impacts the pelvic floor muscle (the muscle that spans the lower part of the pelvis and supports organs such as the bowel, bladder and uterus) and the muscles that contract the bladder.

However, more recent research has found the correlation to be inconclusive. It may have more to do with diet, exercise and family history which is good news because it suggests incontinence shouldn’t necessarily be expected as a normal part of aging. With effort, it can be improved and in many cases, eradicated with pelvic floor muscle exercises.

In some women, changing hormones can affect the health of the bladder and urethra lining and bladder elasticity, impacting continence.

Another key risk at this life stage is weight gain, which adds pressure to the pelvic organs and puts undue stress and strain on the pelvic floor muscle.