Perimenopause: Bladder and Bowel
September 3, 2025
The Perimenopausal Changes No One Warns You About
Perimenopause — the transition period leading up to menopause — is a natural phase in every woman’s life. While symptoms like hot flushes and mood swings are widely discussed, there are other, less talked-about changes that can have just as much of an impact on daily life.
Let’s explore some of the more surprising changes to your bladder, bowel, and periods — and what you can do to manage them.
Bladder: “Why Do I Always Feel Like I Need to Go?”
If you've noticed you're heading to the toilet more often — or feeling an intense need to go, only to pass a small amount — you're not alone. As oestrogen levels decline, the tissues supporting the bladder and urethra can become thinner and less elastic, leading to:
- Increased bladder urgency
- More frequent urination
- A lingering sensation of not quite emptying
What You Can Do
- Try not to respond to every urge straight away. Bladder retraining can help your body adjust and reduce the frequency of urgency over time.
- Avoid common bladder irritants that can make urgency worse. These may include:
- Coffee
- Alcohol
- Artificial sweeteners
- Fizzy drinks
- Spicy or acidic foods (depending on your individual sensitivity)
Bowel: Slower, Smellier, and More Sensitive
Digestive changes are also common during perimenopause. Hormonal fluctuations can slow gut motility, which may result in:
- Increased constipation
- New food sensitivities
- More noticeable (and often smellier) wind
These changes are often unexpected but entirely normal. Supporting your gut health with fibre-rich foods, hydration, and regular physical activity can make a significant difference.
Periods: Heavier, Irregular, and Less Predictable
For many women, perimenopause brings changes to menstrual cycles well before periods stop altogether. You may experience:
- Heavier bleeding than usual
- Irregular cycles — sometimes longer, sometimes shorter
- Spotting or bleeding between periods
Important: Any new spotting or unusual bleeding should be checked by your GP. While often harmless, it’s important to rule out any underlying issues.
You Don’t Have to Just “Put Up With It”
These changes are common, but that doesn’t mean you have to live with discomfort or uncertainty. At Pelvic Health Melbourne, we specialise in supporting women through perimenopause and beyond.
We provide expert care to help you:
- Manage bladder urgency
- Reduce or eliminate after-dribble
- Improve bowel function
- Strengthen pelvic floor health
What We Offer
- Personalised pelvic health assessments
- Evidence-based treatment plans tailored to your needs
- Compassionate, confidential care at every stage of menopause
Book your pelvic health consultation today and take the first step toward feeling more in control of your body — and your life.
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Bedwetting, also known as nocturnal enuresis, is very common in children. It is rarely intentional and is usually part of normal development, especially when children sleep very deeply and do not wake to bladder signals. There are a few reasons this can happen. Some children produce more urine overnight, some have a smaller bladder capacity, and others are still developing the brain–bladder connection needed to recognise and respond to a full bladder during sleep. It can also run in families, so a family history of bedwetting is common. A bedwetting alarm is one of the most effective treatment options. It works by detecting moisture as soon as wetting starts and then sounding or vibrating to wake the child. The aim is for the child to wake, stop urinating, and finish in the toilet. Over time, this helps train the brain to respond earlier to bladder signals during sleep. In the beginning, many children do not wake fully to the alarm and may need a parent to help them get up and use the toilet. With consistent use, this response usually improves, and children gradually start waking on their own. It is important that bedwetting is managed with patience and reassurance. It is not a behaviour issue, and children are not doing it on purpose. Pressure or punishment can make things more stressful and does not help with progress. Alongside alarm use, simple bladder habits can support progress, such as regular daytime toileting, good fluid intake earlier in the day, and managing constipation if present, as this can impact bladder function. Pelvic health physiotherapy can also provide support. A pelvic health physio can help set up and explain how to use a bedwetting alarm, making sure families feel confident from the start. We guide you on where to place the sensor, how to respond when it goes off, and what steps to follow overnight to build consistency. We also help troubleshoot common challenges and adjust the plan if needed, to improve the chances of success. Alongside this, we provide education and a structured plan tailored to the child and family, helping to support progress and confidence over time.
Sexual health is an important part of overall wellbeing, yet it is something many men find difficult to talk about. One factor that is often overlooked is the role of the pelvic floor in sexual function. The pelvic floor is a group of muscles at the base of the pelvis. In men, these muscles help support the bladder and bowel, and they also play a key role in erections, ejaculation, and sexual sensation. When these muscles are not functioning well - whether they are too tight, too weak, or not coordinating properly - it can contribute to sexual difficulties. Some men may experience erectile dysfunction, difficulty maintaining an erection, changes in ejaculation, reduced sensation, or discomfort during or after sex. These concerns can occur at any stage of life and are more common than many people realise. There are a range of factors that can affect pelvic floor function. Stress and anxiety can increase muscle tension, while surgery (such as prostate surgery), prolonged sitting, or chronic pelvic pain can also play a role. Often, it is a combination of factors rather than a single cause. It is also important to recognise the role of the mind-body connection. Stress, performance anxiety, and emotional wellbeing can all influence sexual function. Addressing both the physical and psychological aspects of health often leads to the best outcomes. Pelvic health physiotherapy can help identify how the pelvic floor is functioning and guide treatment. This may include exercises to improve strength or relaxation, breathing techniques, and strategies to reduce tension and improve coordination. Education and small changes can often make a meaningful difference. Sexual dysfunction in men is common, and support is available. Understanding the connection between the pelvic floor and sexual health can be an important step toward improving confidence, comfort, and overall wellbeing.
Pelvic Health Is for Everyone Pelvic health is often talked about as a women’s issue, but in reality it affects people of all genders across every stage of life. The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles also play a role in sexual function and everyday movements like lifting, bending, coughing, or laughing. Because they are involved in so many aspects of daily life, looking after pelvic health is important for everyone. Pelvic health concerns can show up in many different ways. Some people experience bladder leakage, urgency, constipation, or changes in bowel habits. Others may experience pelvic girdle pain, including discomfort around the sacroiliac joints, pubic symphysis, or coccyx (tailbone). Pelvic pain can also occur in the lower abdomen or in the genitals and may affect comfort with sitting, exercise, or sexual activity. These symptoms can affect people of any gender, yet they are often not openly discussed. Pelvic floor challenges can appear at different stages of life. Children may experience constipation, bedwetting, or daytime bladder accidents. Adolescents and adults may notice pelvic pain, bladder urgency, or bowel changes. Men may experience pelvic pain or bladder symptoms, including leakage, particularly after prostate surgery. Older adults may notice changes in bladder or bowel control or pelvic comfort as the body changes with age. While these experiences are common, many people are surprised to learn that help is available. Hormones also play an important role in pelvic health for people of all genders. Changes in hormone levels; during puberty, pregnancy, menopause, or as part of gender-affirming hormone therapy, can influence tissue health, bladder control, sexual function, and comfort in the pelvic region. Understanding these changes and supporting the body with the right care can make a meaningful difference. Pelvic health physiotherapy offers practical support, education, and treatment for many of these concerns. Physiotherapists can help people better understand their pelvic floor, improve bladder and bowel habits, manage pelvic girdle or pelvic pain, and support comfortable movement in daily life. Often, small changes can make a big difference to daily comfort and confidence. Pelvic health isn’t limited to one gender or one stage of life. By talking about it more openly and recognising the many ways it can affect the body, we can make it easier for everyone to seek support and care for their pelvic health.
