What should women during menopause do about urinary incontinence?

Patient's question:

How to improve the distress of urinary incontinence, frequent urination, and discomfort in the vagina and perineum after menopause is to improve the postmenopausal women

Doctor's answer:

Hello: A woman's urethra maintains continence or controls leakage primarily through the force of its smooth muscle, surrounding transverse muscles, the elasticity of the urethral wall, the urethral mucosa, and the blood vessels beneath the mucosa, which work together to close the urethra and prevent urine from leaking. However, after menopause, the lack of hormones not only weakens muscle strength but also causes atrophy of the urethral and vaginal mucosa, as well as a reduction in the number of blood vessels beneath the urethral mucosa, leading to a relative weakening of the force that closes the urethra. Additionally, the lack of hormones reduces the number of receptors in the nerves at the junction of the urethra and bladder, lowering the closing pressure of the urethra. These factors combined make it difficult to resist sudden increases in abdominal and bladder pressure caused by coughing, sneezing, jumping, etc., resulting in urinary incontinence.
For women experiencing urinary incontinence during menopause, there is no need to be overly anxious. It is advisable to remain calm and cooperate with a doctor for thorough examinations and treatment tailored to the specific causes. Mild incontinence generally improves gradually through exercises to strengthen pelvic floor muscles (e.g., forcefully contracting abdominal, gluteal, and perineal muscles after taking a deep breath, or performing sphincter tightening exercises 20 times per hour, twice daily) and treatments such as traditional Chinese medicine and acupuncture. Severe incontinence may require surgical intervention.
Preventing urinary incontinence should start from a young age. To strengthen the external urethral sphincter and pelvic floor muscles, one can perform squatting exercises (20 times per hour) or tightening exercises while sitting. After menopause, estrogen can be taken under a doctor's guidance in appropriate amounts to maintain a certain level of estrogen in the body and prevent incontinence. In daily life, it is important to avoid excessive force that increases abdominal pressure, especially for overweight individuals.