Bladder Issues Overlooked During Menopause Transition

The Menopause Society

New study demonstrates need for better and earlier education on bladder health and potential urinary tract problems during menopause, especially for women using hormones

CLEVELAND, Ohio (April 30, 2025)—The menopause transition is often accompanied by a wide array of symptoms, some of which receive more attention than others. Bladder health and lower urinary tract issues are examples of topics not well studied. A new study focused on the association of menopause status and use of hormones with bladder and urinary tract health. Results of the study are published online today in Menopause, the journal of The Menopause Society.

When most people think about menopause, the most common symptoms that come to mind are hot flashes and night sweats. There has certainly been no shortage of research studies and publicity around these topics. Even when the term genitourinary syndrome of menopause was first coined in 2014 by The Menopause Society (formerly The North American Menopause Society) and the International Society for the Study of Women's Sexual Health, much of the focus was on the genital symptoms, such as painful intercourse and vaginal dryness.

Much less research has been conducted over the years around the urinary implications of menopause. That's why a new study focused on identifying the association of menopause status and hormone use with bladder health and lower urinary tract symptoms. The results of this survey were published in the article " Association of menopausal status and hormone use with bladder health and lower urinary tract symptoms in US women: results from the RISE FOR HEALTH study. "

The study involved more than 3,000 women who were classified as premenopausal, perimenopausal, or postmenopausal. In addition to bringing to light some new findings, the study also confirmed a number of previous findings, including the fact that bladder health typically gets worse with age, as does the risk for incontinence and infections. In addition, hormone use has shown mixed results when it comes to urinary symptoms. Systemic hormone use is specifically associated with a greater incidence of incontinence in postmenopausal women, whereas localized low-dose hormone therapy results in improvements in genitourinary symptoms and urinary tract infections.

New findings from the study include the fact that premenopausal women reported using hormones more often than perimenopausal or postmenopausal women. They also experienced the least difference in bladder health as a result of using hormones. Perimenopausal and postmenopausal women experienced worse bladder health and bladder function compared with premenopausal women. Additionally, hormone therapy use was linked with worse bladder health in postmenopausal women specifically.

Based on the results of this large-scale study, the researchers concluded that the association between menopause status and hormone use with bladder health and lower urinary tract symptoms is complex and multifaceted. They not only recommend additional research in this area but also believe there is value in initiating education programs before women enter menopause, so they recognize any warning signs in time for effective intervention.

"This study highlights the changes in bladder health across the menopause transition. The relationship of hormone therapy with bladder health and lower urinary tract symptoms is more complex and requires a nuanced and individualized approach," says Dr. Stephanie Faubion, medical director for The Menopause Society.

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