Perimenopause and bladder changes

As oestrogen changes during perimenopause, the tissues around the vagina, urethra, and bladder may become drier or more sensitive. You may need to pass urine more often, feel a sudden urge, leak with coughing or exercise, wake to urinate, or feel discomfort during sex. These symptoms can also result from a urinary infection, constipation, pelvic-floor changes, diabetes, medicines, or another bladder condition. Urgency with burning or cloudy, strong-smelling urine should not be written off as hormones.

Keep a short bladder diary: record drinks, urgency, leakage, pain, urine changes, and night-time trips. Drink regularly rather than severely restricting fluids, and notice whether caffeine, fizzy drinks, or alcohol aggravate urgency. Treat constipation, avoid rushing to the toilet, and consider pelvic-floor physiotherapy for leakage or urgency. A clinician can assess urine and discuss vaginal or bladder treatments suited to your health history.

Contact a clinician promptly for burning, fever, back or side pain, blood in the urine, new difficulty emptying the bladder, or symptoms that are rapidly worsening. Seek urgent care if you cannot pass urine, feel severely unwell, or have intense pain. Recurrent leakage, urgency, or vaginal dryness also merits review because treatment can improve comfort and protect daily activities.

Ask whether you need a urine test, pelvic examination, or review of medicines. Discuss pelvic-floor therapy, bladder training, and options for dryness or urgency, including how each fits with your medical history and any pregnancy possibility.