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Hormones & Bladder Pressure

Hormones are responsible for so much of what makes your body function on a daily basis. From regulating cells and tissue to influencing mood and behavior, nearly every bodily function can be routed back to hormones. This can include causing cravings during pregnancy and the menstrual cycle as well as fluctuations in libido. 

Hormonal fluctuations in a woman's cycle can also cause increased instances of urinary incontinence. Understanding how hormones can impact your body can help you prepare for when you may need extra assistance and protection. 

These molecules not only influence moods and behaviors, but they also regulate specific cells and tissues. Maybe you feel cranky sometimes and can't figure out why, or you have intense cravings out of nowhere. Perhaps you've noticed that leaks are more common during one part of your cycle over the other. In all of these instances, hormones may be responsible. Use this guide to get to know your body better and learn what hormones have to do with incontinence.

Hormones and Your Pelvic Floor

The pelvic floor is a group of muscles that stretch over the pelvic bone. In women, it's responsible for supporting the uterus, ovaries, bowel, and bladder, among other abdominal organs. The constantly fluctuating hormones women experience can directly impact this area. This can happen at specific times, such as during a normal menstrual cycle, pregnancy, perimenopause, or menopause, all of which can dramatically change the hormonal structure of the body. 

In particular, there are three hormones that can affect dramatic change in the pelvic region: estrogen, progesterone, or testosterone. 


Estrogen regulates several functions in the female body, including puberty, menstruation, ovulation, and pregnancy. As women age, this hormone becomes less abundant. As it does during puberty, your body changes again in your 40s and 50s during perimenopause and menopause.

Declining levels of estrogen can contribute to several pelvic floor symptoms, including bladder or bowel leaks, a sudden urge to urinate or the urge to urinate more frequently, sexual dysfunction or pain during vaginal penetration, difficulty getting urine flowing, or a feeling of pelvic heaviness. 


Progesterone is the hormone that relaxes smooth muscles, such as the tissues surrounding your urethra. Too much of this hormone can lead to leaks. In fact, urinary incontinence is one of the many symptoms associated with excessive progesterone levels. 

Progesterone levels naturally increase during pregnancy and a few days after ovulation during a woman's monthly cycle, leading to potential increase in incontinence symptoms during these times.


While it's commonly thought of as a male hormone, women need testosterone to function as well. Women produce testosterone in their ovaries and fat cells as well as their adrenal glands and skin cells. Testosterone combined with estrogen enables women's bodies to grow, maintain, and repair bone mass, reproductive tissues, and muscle mass. Healthy testosterone levels are also linked to better moods, enhanced cognition, and maintaining a healthy sex drive.

Because testosterone helps build skeletal muscle, it's also related to the pelvic floor. Without the right testosterone levels to support the development of the muscles in the pelvic floor, leakage can occur. In fact, women with low testosterone levels are found to have a significantly higher risk of both stress and mixed incontinence.

Periods and Bladder Leaks

The menstrual cycle is controlled by several glands and hormones, but it can be broken down into four phases: menstruation, the follicular phase, ovulation, and the luteal phase. All four of these phases are controlled by hormones. When those hormone levels are out of balance, so are other functions, such as menstruation. It can also lead to leakage, especially during the earliest stages.

The first phase of the cycle is menstruation, commonly referred to as a period. During menstruation, women shed their uterine lining through the vagina, passing a mixture of blood, mucus, and lining cells. It often lasts three to seven days. During this stage, progesterone levels peak, which causes the uterine lining to stop thickening. 

The follicular phase is the second stage and starts on the first day of menstruation and lasts until ovulation. During this stage, the pituitary gland releases hormones to stimulate the ovary to produce a follicle, which becomes an egg that is released during ovulation. Halfway through this stage, estrogen levels rise.

The third stage in the menstrual cycle is ovulation. During this stage, the uterus thickens its lining to prepare for a potential pregnancy. Progesterone levels rise during this stage and estrogen levels drop again. 

The final stage of the menstrual cycle is the luteal phase. During this phase, the cells in the ovary release progesterone and a small amount of estrogen to prepare the uterus for pregnancy.

As the levels of estrogen and progesterone fluctuate, so do the risks of leakage and incontinence symptoms. During periods of high progesterone and low estrogen, it's more common to need incontinence products such as Nexwear's protective incontinence underwear.

Take a moment to imagine the up and down motions of a roller coaster. This visual is similar to the ever-changing hormone levels during your monthly menstrual cycle. The menstrual cycle begins on the first day of your period. At this stage, estrogen levels are low. The lower estrogen levels make you more likely to experience leakage and need more bladder leak products in this stage. Hormones during pregnancy can also cause bladder leaks.

Pregnancy, Hormones, and Bladder Leaks

Pregnancy is known to cause all sorts of changes in the body. During a pregnancy, both estrogen and progesterone levels increase to support the developing fetus. Of course, the fetus also needs to have room to grow as well, resulting in a need for organs to shift to accommodate the rapidly growing uterus. This requires tissues to soften. 

Although low levels of estrogen are commonly associated with leakage, as estrogen levels increase during pregnancy, many women still see an increase in incontinence symptoms. This is because progesterone levels rise in tandem with rising estrogen levels.

Progesterone levels cause the loosening of joints and ligaments women experience during pregnancy that allows their bodies to accommodate and support a growing baby. As the pelvic floor relaxes and as the baby grows larger and sits on a woman's bladder, incontinence symptoms may increase.

Pregnancy comes with some significant hormonal and physiological changes. Estrogen and progesterone levels steadily increase during pregnancy to help the fetus properly develop. Organs shift and tissue softens due to the increase in progesterone. The result is a relaxed pelvic floor with a growing baby and organs putting pressure on your bladder. Between the hormones and bladder pressure created by the growing fetus, women experience a combination that greatly increases the chance of leaks.

Perimenopause and Leakage

Most women begin experiencing perimenopause in their late 30s or early-to-mid 40s. It's a stage in their lives when the ovaries start to make less estrogen and stop releasing eggs. During this period, some women experience what is called the estrogen roller coaster, which is when estrogen levels go up extremely high and before plummeting again to much lower levels. Other women experience a slow and gradual decline in estrogen, which is classified as low estrogen perimenopause.

The stage of perimenopause can last 7 to 14 years, and women can experience range of symptoms over this stage. Because of the decrease in estrogen, pelvic floor muscles weaken gradually during perimenopause, making bladder control more challenging. One of the first signs of perimenopause is overactive bladder. This can present as the urge to urinate more frequently or to experience leakage when sneezing or coughing. Trips to the bathroom at night or more than 8 trips in a day are also telltale signs. However it presents, overactive bladder is an almost universal experience during the perimenopause stage.

Menopause, Hormones, and Leaks

Menopause occurs in women between the ages of 45 and 55. This stage in a woman's life indicates that she has not had a period for at least a year. The aging ovaries produce less luteinizing hormone and follicle stimulating hormone, and in turn there is a significant drop in estrogen levels. During this time, the urethra becomes less flexible and drier, which can make the urge to urinate more frequent and urgent. In addition, the pelvic floor and its surrounding ligaments are weaker and less elastic.

Due to weakening ligaments and a lack of elasticity in the pelvic area, leaks can become more common during menopause. Stress incontinence may become more extreme, causing increased leakage during coughing, sneezing, laughing, or other strenuous activities. Mixed incontinence, which involves both stress and urge incontinence symptoms, may also become more frequent. 

The Bottom Line

Hormones and bladder pressure go hand in hand. Hormones have a significant effect on women's pelvic floors and, in turn, bladder leaks. Ways to combat this include starting therapies, such as medication and implementing Kegels to strengthen the pelvic floor (with your doctor's approval), buying bladder leak products to use as a protective barrier, or eliminating bladder irritants from your diet to reduce leaks as they become more frequent. While urinary incontinence can be frustrating and embarrassing to deal with, it's not something you have to face alone or without support. You don't have to stop doing the things you love because of incontinence symptoms. Nexwear is here to offer discreet, dependable incontinence pads and underwear that can keep you covered through any stage. Even better, Nexwear delivers products right to your door.