Changing pelvic floor muscles: As your body matures, you might experience your pelvic muscles ‘relaxing’ over time or growing weaker. This may be accentuated by a history of childbirth (even by caesarean delivery), chronic constipation, high-impact exercise, and being overweight. As the connective tissue loosens and the muscles lose tone, the support of the pelvic floor decreases which can cause herniations of the bladder and rectum into the vagina, and prolapse of the pelvic organs. Clinical symptoms of this may include stress incontinence, mixed incontinence, feeling pelvic pressure, feeling a ‘bulge’, and having to place a finger in the vagina to successfully defecate.

Changing hormone levels: including oestrogen, which gradually decreases after menopause and affects the tissues of the vagina, vulva, and urethra. As these tissues thin and have less lubrication, urinary tract infections become more common, along with vaginal dryness. This might also cause you to experience sexual difficulties during your menopause years. Decreasing oestrogen levels may also cause night time hot flushes, frequent awakenings, and nighttime bathroom trips.

Women often relate bladder changes as a normal part of ageing. While bladder changes may be typical, they are not inevitable and can be tackled, leading to better urinary tract health and quality of life.