Bladder Control Problems & Your Period

From bloating to painful cramps to breakouts, many inconvenient symptoms accompany your period, but did you know incontinence may be another symptom?

That’s right: Urinary incontinence is being reported as a side effect of menstrual cycles in women. While there isn’t much research to back it up yet, it’s being noticed by the healthcare community.

This post will address why you may be experiencing incontinence during menstruation— known as cyclical incontinence—and what you can do to help ease your symptoms.

What Is Urinary Incontinence?


Urinary incontinence is described as the loss of bladder control. There are a few types of urinary incontinence:

Stress incontinence: Stress urinary incontinence (SUI) occurs when abdominal pressure is placed on your bladder when you sneeze, cough, laugh, or engage in physical activities such as exercising or heavy lifting.

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The pressure put on your bladder during these activities causes leakage. SUI is more common among women than men.

Overactive bladder: You may be able to tell if you have an overactive bladder (OAB) if you feel the need to urinate urgently or more than usual (more than eight times a day). You may also feel the need to wake up in the night to pee. OAB can be caused by weak pelvic floor muscles, certain medications, bladder irritation, being overweight, or infections like urinary tract infections (UTIs).

Woman experiencing incontinence speaking with doctor.Woman experiencing incontinence speaking with doctor.

Urge incontinence: Urge incontinence is similar to OAB; You feel the need to urinate frequently and urgently. Urge incontinence usually leads to urine leakage if you can’t make it to the bathroom on time or if your pelvic floor muscles or urethral sphincter are weak.

Overflow incontinence: Overflow incontinence is just that: An overflow of urine from your bladder. This occurs when your bladder holds in urine and doesn’t empty completely, known as urinary retention. When you have overflow incontinence, urine leaks or dribbles from your bladder.

Mixed incontinence: Mixed incontinence occurs when you experience multiple types of incontinence at once. Symptoms are based on what kind of incontinence you are managing.

Learning about incontinence and periodsLearning about incontinence and periods

Women and men can experience each type of incontinence listed, but sometimes female urinary incontinence occurs due to pregnancy, childbirth, menopause, or menstruation.

Incontinence can be a lot to manage, especially if you’re also experiencing premenstrual symptoms (PMS) at the same time. One way to help manage these symptoms confidently is by using incontinence supplies, and an even better way is by getting your incontinence products for free. Aeroflow Urology can help you get incontinence supplies, such as disposable briefs or bladder pads, through your insurance. Read on to find out how.


Quickly check if you qualify to receive free incontinence supplies. 


Your Menstrual Cycle


You may know the basics of what happens during your period, but to understand how it relates to incontinence, we’ll go into more detail.

Your menstrual cycle starts when you get your period (begin to bleed) and lasts anywhere from 24 to 38 days, resetting at the end.

This cycle usually happens every month in women who have reached puberty and are premenopausal, although there are medical and physical reasons why someone may not get their period. Females typically have their first period around age 12 and stop bleeding when they reach menopause, usually in their 50s.

Ovulation occurs in the middle of the menstrual cycle when an egg is released from your ovary to be fertilized by sperm.

You begin your period (otherwise known as menstruation) if the egg your body released was not fertilized. If the egg isn’t fertilized, your body does not need to prepare the uterus for a growing baby, so your progesterone and estrogen levels drop, and that signals your body to “start your period.”

Calendar for periodsCalendar for periods

Release of Hormones


Your body releases four different hormones, all in the name of reproduction. These hormones also work together to regulate your period. We’ll focus on estrogen and progesterone in this post.

Progesterone is a hormone released by your ovaries during your menstrual cycle. Its primary function is to prepare your body for pregnancy in case an egg is fertilized during ovulation. During this time, progesterone levels rise for about five days.

Estrogen is the hormone that maintains your reproductive and sexual health. It is why women have periods, can get pregnant, experience menopause, and have breasts and wide hips. Estrogen is released in your body before and during ovulation and thickens the uterine lining to get your uterus ready for pregnancy.

Two women eating on their periodTwo women eating on their period

The menstrual cycle releases these hormones during three stages:

  1. The follicular stage: This is the stage before your egg is released. During this stage, levels of estrogen and progesterone are low.
  2. The ovulatory stage: In the ovulatory stage, your body releases an egg for fertilization, your estrogen levels drop, and progesterone increases.
  3. The luteal stage: This stage occurs after your egg is released. During the luteal phase, your progesterone and estrogen levels are high.

The fluctuation of progesterone and estrogen is why you experience symptoms during your cycle and while on your period. Most women experience premenstrual syndrome (PMS) about one to two weeks before bleeding begins. 

Causes of Cyclical Incontinence


So, why does incontinence happen during your period? Well, while there isn’t much urodynamic research to explain the relationship between a woman’s menstrual cycle and urinary incontinence, healthcare providers are noticing the prevalence of incontinence symptoms during women’s periods.

On top of women reporting incontinence symptoms during their cycles, new studies are digging deeper into the effects the menstrual cycle has on the bladder and female continence.

Progesterone, the Detrusor, & Incontinence


Hormones during your period that cause incontinence.Hormones during your period that cause incontinence.
Low levels of estrogen & high levels of progesterone cause physical changes that may lead to incontinence.

One study found that it’s common for women to experience incontinence during their periods. The study included 133 pre-menopausal women with regular periods who were not taking hormones. Out of the 133 women, 41% reported experiencing incontinence at different times during their periods.

  • 42% found incontinence was worse right before their period.
  • 36% found incontinence was worse during their period.
  • 15% found incontinence to be worse in the middle of the month.
  • 7% found incontinence to be worse immediately after their period.
Graph of incontinence during your periodGraph of incontinence during your period
Study results from 133 women experiencing incontinence during their menstrual cycles.

The detrusor muscle lines your bladder and squeezes inward when you pee, helping to push urine out the bladder through the urethra. If the detrusor muscle’s activity increases or is unstable, it can cause incontinence symptoms (e.g., the sudden urge to pee or frequent urination) linked to urge incontinence, SUI, overflow incontinence, and OAB.

Because we know progesterone levels increase after ovulation, it’s suggested that these high levels of the hormone may cause an uptick in detrusor activity.

Another study that used detrusor tissue and progesterone found that progesterone levels did, in fact, directly affect detrusor muscle contractions.

Progesterone also tells your body to let go of all the fluid it held onto during your period, including urine. When this happens, you may feel the need to void more frequently, which is the main symptom of OAB.

Takeaway: If progesterone levels are going up during and after your cycle, and progesterone causes your bladder to contract more frequently, it may cause incontinence. Progesterone also causes your body to release fluid, leading to symptoms related to OAB.
Lady resting on the couch during her period.Lady resting on the couch during her period.

Estrogen, the Pelvic Organs, & Incontinence


We know that estrogen plays a huge role in women’s health. It is the reason for your period, pregnancy (if you decide that’s right for you), and menopause. It’s why you may look different from a male. Basically, estrogen controls a lot of what happens in women’s bodies.

Not only is estrogen released throughout your menstrual cycle, but our pelvic organs and pelvic tissues are also responsive to it. This means that those parts of your body change as the levels of estrogen change. Low estrogen levels cause a change in abdominal pressure, making the pelvic floor muscles and ligaments surrounding your pelvic floor decrease in strength and increase in stiffness, which may lead to pelvic floor disorders and different types of incontinence.

Estrogen levels can also change the positioning of your cervix, which directly affects the strength of your sphincter and urethra. This change can make it challenging to void your bladder and stop urine from leaking out.

Takeaway: The low estrogen levels during menstruation alter abdominal pressure, causing your urethra and pelvic floor muscles to weaken, leading to incontinence.
Females and incontinenceFemales and incontinence

Tampons, the Urethra, & Incontinence


Hormones aside, there’s one other suspect that could cause incontinence during your period: Period products! When you put a tampon in your vagina, you change the pressure inside your abdomen. This change in pressure can make your bladder muscles tighten or loosen, leading to incontinence symptoms, such as urinary retention and leakage.

Leakage while using a tampon may also be a sign of bladder prolapse, also known as a cystocele. Cystoceles can occur after childbirth, constipation, lifting heavy objects, chronic coughing, or pressure on the pelvic muscles. When you have a cystocele, the walls between your bladder and vaginal wall are weakened and cause your urethra to “kink.” This can block the urine from flowing out properly. Still, when you use a tampon, it can do what a vaginal pessary usually does (more about that below) and open the urethra to allow urine to flow, leading to leakage.

Period productsPeriod products
Takeaway: Menstrual products, like tampons, can cause changes in your abdominal pressure, causing urinary retention and leakage. Tampons can also cause leakage by unknowingly fixing a pre-existing urine flow issue.

How to Manage Incontinence


If you’re experiencing incontinence during your period or your cycle, it can change your quality of life. But don’t worry—there are many treatment options available. You can speak with a healthcare professional, like your gynecologist, about a treatment plan or try out some simple at-home treatments.

1. Pelvic Floor Exercises

Also known as Kegel exercises, these exercises can help improve the strength of your pelvic floor and your sexual function and sexual health. Even if you don’t have incontinence, you should do pelvic floor exercises to help keep your pelvic area strong and continent.

2. Incontinence Products

If you find that you’re leaking through your clothes or just want help managing your incontinence, incontinence products may be the answer. Protective adult underwear or bladder pads can help absorb leaks and keep you dry and worry-free. Find out if you qualify to receive incontinence supplies free through your insurance.

How to manage incontinence symptomsHow to manage incontinence symptoms

3. Lifestyle Changes

Making specific lifestyle changes may be able to help you manage your incontinence. For example, drink lots of water, eat foods that are good for your bladder, exercise, and avoid bladder irritants like caffeine, alcohol, and certain spices.

4. Medications & Surgeries

Speak with your healthcare professional about which medicines may be able to help with incontinence symptoms, or talk to your provider about bladder Botox injections or vaginal pessaries.

5. Weight Management

Maintaining a healthy weight is helpful when managing incontinence symptoms since the extra weight can put pressure on your bladder and increase incontinence symptoms. Therefore, aim for a healthy amount of weight loss and exercise to keep your incontinence in control.

Happy women talking about periodsHappy women talking about periods

Can I Get Incontinence Products for Free?


Aeroflow Urology knows managing incontinence symptoms can be difficult at times, especially if you’re also managing symptoms of menstruation. Let us do the work for you regarding incontinence care by sending you free incontinence supplies, such as bladder pads, every month.

How Aeroflow Urology Can Get You Incontinence Supplies 


If you have a pre-existing condition that causes incontinence, your Aeroflow Urology, along with your Medicaid or private insurance plan, may be able to help. Here’s how it works:

Step 1. Fill out our eligibility form.

Step 2. Once you’ve submitted the form, one of our Continence Care Specialists will reach out to let you know if you’re eligible. From there, we’ll guide you through our products and give you a curated shopping list to choose your incontinence supplies from. Our specialists will help you select the perfect products for you!

Step 3. After choosing your products, they’ll be shipped directly to your door in discreet packaging. We’ll send you email or text reminders each month to let you know when it’s time to resupply.

References:

Progesterone - Health Encyclopedia - University of Rochester Medical Center. (n.d.). Www.urmc.rochester.edu. Retrieved April 7, 2022, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=progesterone#:~:text=After%20ovulation%2C%20progesterone%20levels%20go

Hextall, A., Bidmead, J., Cardozo, L., & Hooper, R. (2001). The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation. BJOG: An International Journal of Obstetrics and Gynaecology, 108(11), 1193–1196. https://doi.org/10.1111/j.1471-0528.2003.00280.x

Shenfeld, O. Z., McCammon, K. A., Blackmore, P. F., & Ratz, P. H. (1999). Rapid effects of estrogen and progesterone on tone and spontaneous rhythmic contractions of the rabbit bladder. Urological Research, 27(5), 386–392. https://doi.org/10.1007/s002400050168

Menstrual Cycle - Women’s Health Issues. (n.d.). Merck Manuals Consumer Version. Retrieved April 7, 2022, from https://www.merckmanuals.com/home/women-s-health-issues/biology-of-the-female-reproductive-system/menstrual-cycle#:~:text=Luteinizing%20hormone%20and%20follicle%2Dstimulating

https://drlaurenkeller.com/blog/2018/5/24/urinary-leaking-your-period#:~:text=This%20helps%20us%20better%20understand,stop%20the%20flow%20of%20urine.

Disclaimer

Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.

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