Here’s a menopause symptom lots of women don’t talk about…but it can happen: bladder spasms, which include bladder control issues. Although this symptom can be uncomfortable and embarrassing, you can learn to manage it so it doesn’t manage you.

What are bladder spasms?

Normally, the bladder fills up gradually with urine, and you begin to feel the urge to urinate over time. A bladder spasm, however, is like going from zero to 60 in a few seconds. It occurs when the bladder muscle contracts involuntarily and without warning, resulting in a sudden and urgent desire to pee. The spasm can be strong enough to force urine out of the bladder, resulting in leakage. If leakage does occur, the condition is called overactive bladder or urge incontinence. 

Read about menopause and urinary incontinence

Bladder spasms can be mild to severe and feel like menstrual cramping and may also cause a burning sensation. They can be caused by various factors, such as older age, diabetes, obesity, pregnancy, muscle or nerve damage, catheter use, certain foods (e.g., alcohol, spicy foods, citrus, chocolate), interstitial cystitis, urinary tract infection, multiple sclerosis, recent pelvic or lower abdominal surgery (e.g., hysterectomy), or menopause.

How are bladder spasms associated with menopause?

Declining levels of estrogen have an impact on countless numbers of areas and functions in the body. Among them are the bladder and the surrounding muscles, vagina, and urethra. As the hormone level drops, the tissues that line the vagina get thinner. This in turn reduces the strength and elasticity of the vagina and the muscles around it, resulting in less muscle support for the bladder and urethra.  

All of these changes make women more susceptible to bladder spasms and the urinary issues that can accompany them, including incontinence, urinary pain, and overactive bladder. 

Read about menopause and urinary tract infection

How to manage bladder spasms naturally

You don’t have to be a slave to your bladder problems. Here are some tips on how to manage bladder spasms naturally.

• Identify any medical problem. Some medical conditions, such as a urinary tract infection or interstitial cystitis, may be the cause of your spasms. Work with your healthcare provider to remedy these conditions.
• Adopt new bathroom habits. It may help if you establish a routine urination program. For example, urinate every 60 to 90 minutes. This may help prevent leakage. Over time you can extend your bathroom trips to 2 hours or more.
• Examine your diet. Some foods, such as alcohol, spicy foods, citrus, pickled foods, caffeine, and anything containing artificial sweeteners may contribute to bladder spasms. Eliminate these items from your diet for several weeks to see if there is any improvement.
• Try Kegel exercises. Kegel exercises help strengthen the pelvic floor muscles and can be done just about anywhere, anytime. To do these exercises, imagine you are trying to stop peeing. The muscles that you constrict to prevent urination are called the pubococcygeus (PC) muscles. To do Kegels effectively, constrict your PC muscles and hold for about 10 seconds, then release and relax for 10 seconds, and repeat the cycle 10 times. Do Kegels three to four times a day. You should begin to notice results after about three to six weeks. 
• Use vaginal weights. Some women find that using vaginal weights is an effective way to strengthen pelvic floor muscles and manage urine leakage. The cone-shaped weights are inserted into the vagina like a tampon and held in place by contracting the pelvic floor muscles. With regular practice, you can strengthen those muscles and achieve better bladder control. 
• Investigate biofeedback. Research has shown that a combination of Kegel exercise and biofeedback can be effective in relieving bladder spasms. Sessions are often done with a qualified therapist, but you also can purchase biofeedback units to use at home.
• Try TENS. Transcutaneous electrical nerve stimulation (TENS) is a device that sends very mild electrical pulses to the bladder through patches that you apply to your skin. The pulses may boost blood flow and the release of hormones that help reduce pain. TENS units are available over the counter.
• Join a support group. Speaking with other women in menopause who are experiencing bladder spasms may provide you with some ideas on how to better manage your symptoms as well as help you feel like you’re not alone.

When to call your doctor

If you are not successful managing your bladder spasms naturally, the symptoms are getting worse, your daily activities are affected, or you are experiencing other symptoms such as fever, other bladder issues, or unusual pain, contact your healthcare provider as soon as possible. 

Bottom line

Bladder spasms may result in urinary incontinence or overactive bladder, which can disrupt your daily activities. Try natural ways to remedy this symptom of menopause or consult with your physician.