What is it about?
This narrative review examines urinary incontinence in women during and after menopause, summarizing published research on its clinical patterns, associated risk factors, and treatment options. It discusses stress, urgency, and mixed urinary incontinence, explaining how their relative frequency changes with age and time since menopause. Particular attention is given to obesity, obstetric history, hormonal changes, associated medical conditions, and medication-related effects. The review also explores nighttime urinary symptoms, distinguishing nocturia from involuntary urine leakage, and examines coital incontinence and its effects on sexual well-being. Treatment options include pelvic floor muscle training, electrical stimulation, local vaginal estrogen, selected pharmacological approaches, minimally invasive procedures, and surgery. The review emphasizes individualized care rather than a single treatment suitable for all patients.
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Why is it important?
Urinary incontinence is frequently underreported and can substantially affect daily activities, sleep, sexual health, emotional well-being, and quality of life. A key point of this review is that urinary symptoms in menopausal women cannot be explained by hormonal changes alone. Aging, body weight, obstetric history, medication use, and associated conditions also contribute to their development and severity. The article highlights the importance of distinguishing different types of urinary incontinence before selecting treatment. It discusses pelvic floor rehabilitation as an important conservative approach and examines how additional treatments may benefit selected patients. However, evidence for some combined and emerging interventions remains limited, making further comparative research and long-term follow-up necessary.
Perspectives
As a co-author and a physician specializing in Physical Medicine, Rehabilitation, and Balneology, I consider the individualized rehabilitation perspective particularly relevant to this review. Urinary incontinence during and after menopause should be evaluated in the broader context of pelvic floor function, associated genitourinary symptoms, comorbidities, and quality of life. Pelvic floor muscle training is an important component of conservative management, while additional interventions should be selected according to the type of incontinence, the available evidence, and individual patient needs. The discussion of emerging approaches, including balneotherapy, also identifies opportunities for future interdisciplinary research. However, evidence of microvascular changes following balneotherapy does not establish clinical effectiveness for urinary incontinence, and dedicated studies are required.
Dr Traian Virgiliu Surdu
Universitatea Ovidius din Constanta
Read the Original
This page is a summary of: Involuntary Urine Loss in Menopause—A Narrative Review, Journal of Clinical Medicine, October 2025, MDPI AG,
DOI: 10.3390/jcm14217664.
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