What's really happening
As estrogen levels drop and pelvic floor muscles weaken, your bladder and urethra lose some of the strength and support they used to have. That can lead to leakage—whether from a sudden urge to pee (urge incontinence), pressure on your bladder (stress incontinence), or a bit of both.
But why?
Declining estrogen = weaker bladder control, thinner urethral lining, and less pelvic floor support.
Scientific Breakdown
Estrogen helps maintain the strength and flexibility of tissues around the bladder and urethra. As hormone levels drop, these tissues become thinner, less elastic, and more prone to leaks—especially under physical stress like sneezing, laughing, or jumping. In some cases, nerve signals to the bladder may also become more sensitive or less reliable.
• ↓ Estrogen → thinning of urethral and vaginal tissue
• ↓ Collagen → weaker structural support
• ↓ Pelvic muscle tone → less control
• Vaginal dryness → irritation, discomfort, increased urgency
Essentially…
When hormone levels shift, the muscles and tissues that hold everything in place… don’t hold as well. That can lead to unexpected leaks—especially when you’re active.
See a doctor if …
• Leaks are interfering with your sleep, exercise, or confidence
• You’re unsure if it’s incontinence or another issue (e.g., infection)
• Symptoms are getting worse or affecting your emotional wellbeing
• UTI
• Pelvic organ prolapse
• Neurological issues (rare)
Frequently Asked Questions (FAQs) about
Urinary Incontinence (Leaks)
Q: Is this just a normal part of aging?
It’s common—but it’s not inevitable. You deserve real solutions.
Q: Will vaginal estrogen actually help?
Yes. It improves tissue tone and moisture, which supports the urethra.
Q: Do I need surgery?
Often, no! Most women improve significantly with conservative treatment.
“I thought peeing my pants during workouts was just part of getting older. Then I got on vaginal estrogen and worked with a pelvic floor therapist—and now I can run again without fear. I feel strong.”
— FLUXX community member, age 49
FLUXX Recommendations
1. Try local vaginal estrogen to support urethral and vaginal tissue
2. Add pelvic floor physical therapy (yes, it works!)
3. Avoid bladder irritants and time your bathroom trips
Non-Hormonal Medications
• Anticholinergics or beta-3 agonists (for urge incontinence)
• Vaginal pessary (for stress incontinence, used under medical guidance)
• Pumpkin seed extract
• Acupuncture (early evidence shows promise)
• Biofeedback-based pelvic training
Lifestyle Suggestions
• Kegel exercises (DIY or guided by pelvic PT)
• Timed voiding (train your bladder)
• Absorbent underwear (short-term support without shame)
Myth-Busting
You’re not broken. And no, this doesn’t mean you need surgery.
Modern Guidance
Pelvic floor therapy and vaginal estrogen can improve bladder control. HT may help some women. You’re not stuck with pads forever—many women reverse this symptom with support and targeted care.
Ask yourself
• “Do you leak when you laugh or cough—or when you suddenly feel the urge?”
• “Would you prefer a low-dose local option first?”
• “Are you open to physical therapy?”
Ask your doctor
• “Could vaginal estrogen help reduce leaks?”
• “Can you refer me to a pelvic floor physical therapist?”
• “Would a pessary or other device be helpful?”
Vaginal estrogen is low-risk and highly effective for supporting urinary tissue—especially when used locally.
