Perimenopause urinary symptoms: what to know

You may need to pass urine more often, feel a sudden urge, leak when coughing or exercising, or wake during the night. Reduced oestrogen can make vulval and vaginal tissues thinner and drier, which may alter comfort during urination and intimacy. Burning, cloudy urine, fever or pain in the back can point to a urinary infection rather than a menopause-related change. Pregnancy can still occur while periods are changing, so a missed period deserves consideration if it fits your circumstances.

Record timing, triggers, leakage and drinks for several days. Sip fluids regularly rather than severely restricting them, and notice whether caffeine, alcohol or fizzy drinks worsen urgency. Avoid holding urine for long periods, keep the area gently clean, and consider pelvic floor exercises guided by a trained clinician. A clinician can check for infection, review medicines and discuss bladder training or local treatment when dryness contributes.

Arrange prompt medical assessment for blood in the urine, fever, chills, vomiting, new back or side pain, or painful urination. Seek urgent help if you cannot pass urine, feel very unwell, or have sudden severe pain. Make an appointment for persistent leakage, repeated infections, worsening urgency or symptoms that disturb sleep, because treatable causes should be checked.

Ask whether your pattern fits bladder changes, infection, pelvic floor weakness or tissue dryness; which tests are needed; and which exercises or treatments suit your health history.