As if menopause insomnia wasn’t bad enough, our sleep is now interrupted by at least two, if not more, trips to the loo. Every night. A full eight hours’ rest feels like a thing of the past thanks to our midlife bladders. If only we knew how to avoid peeing in the middle of the night.
“Urinary incontinence is common among middle-aged women, with 30-40 per cent of them experiencing it,” says Emma James, a physiotherapist who specialises in women’s pelvic health issues. It ranges from the inconvenient (those 1am, 3am and 5am loo trips) to the debilitating (uncontrolled bladder leakage). “Just because it’s common, doesn’t mean women have to put up with it,” says Emma. “There are things that they can do.”
Your midlife bladder
It won’t surprise you to hear that the common cause of peeing in the middle of the night is your hormones. As our oestrogen levels drop in midlife, the muscles that support our pelvic floor weaken. “It can happen to any woman, at any age, but it often occurs around the menopause,” says Dr Shahzadi Harper, a women’s health and menopause doctor. “This is due to declining oestrogen levels, which reduce the elasticity in pelvic floor muscles, causing them to weaken, so the bladder is not fully supported.”
Positive pelvic floor health
Emma James, who is offering free online pelvic health screenings to help women determine the best course of treatment, says that pelvic floor health can be improved in just 12 weeks. “Over a 12-week period, strength and conditioning exercises for the abdominals, glutes, adductors and hamstrings, in combination with a pelvic floor trainer, will give fabulous results.” So this is how to avoid peeing in the middle of the night!
Exercise your pelvic floor
Most of us know about the clenching pelvic floor muscles – but most of us never do them. “If women did their pelvic floor exercises regularly (the NHS recommends three times daily), it would help improve their bladder leakage,” says Julia Herbert, consultant physiotherapist and clinical director for Pelviva, which treats the cause of bladder leakage by training pelvic floor muscles correctly. It’s a non-surgical answer to treat bladder leakage.
However Pelviva research shows that although 73% of us know that the exercises will help, only 31% of us actually do them!
The rise of the wild wee
The recent spate of lockdowns has provided an extra incentive to work on our pelvic floor health – and it’s not just the nightly loo trips. In the UK, lockdown meant the closure of all public toilets, and the shutdown of all the shops, cafes and pubs that most of us are used to popping in to.
The dilemma for midlife bladders in a time of zero toilets, even made the national UK news. MPowered Women founder Saska Graville, writing in the Sunday Telegraph, christened the issue “Lockdown Loo-Gate”, and shared her own story of having to resort to a “wild wee” whilst out and about on a long walk.
It’s an issue that she also spoke about on Emma Barnett’s BBC Radio 5 Live show. Her confession? Popping behind a bush on London’s Hampstead Heath for what Saska dubs an “anxious crouch” Not a happy state of affairs.
Lockdown Loo-Gate is a Sexist Issue
In the Daily Mail, Saska argues that shutting down toilets is a sexist state of affairs. “If 40% of middle aged men felt that they couldn’t be away from home for more than an hour without being caught short, would we be having this debate?” says Saska, about the closure of public toilets. “Of course not. But no man has ever had to plan an afternoon’s walk around where to find the best comfort breaks or have a ‘safety wee’ before he heads off on a car journey. No man has ever looked at a trampoline at a kids’ party and worried about leakage. And if a man does get caught short, the physical logistics are pretty straightforward, no anxious crouch required.”
How to avoid peeing in the middle of the night
The expert advice is clear: do your pelvic floor exercises, add in some strengthening for your abs and glutes, and maybe try a pelvic floor trainer like Pelviva. And if you spot another midlife woman having an “anxious crouch”, give her an understanding smile. We’re all in this together after all.