Opinion
The impact of menopause and ageing on urinary incontinence in women
By Lydia Zeller, CEO at Pelvital USA
The natural processes of menopause and ageing are not the biggest challenge women face when it comes to incontinence. The biggest challenges are the historic silence and assumption that our only options are pads or surgery.
One of the most rewarding aspects of my role as CEO of Pelvital is amplifying the conversation around women’s health, especially on historically stigmatised topics like urinary incontinence (UI) and menopause.
If you suffer from bladder leaks, you’re not alone. Research from 2022 shows more than 60 per cent of US women suffer some form of bladder leaks. It is unacceptable that an issue impacting over half of women has historically been kept quiet and stigmatised.
Women are led to believe that bladder leaks are a natural part of being a mum or growing older. That is not true. Although bladder leaks are common, they are not normal, and women should not accept them as such.
Fortunately, there are effective options for treating leaks and education is the first step in self-advocacy – one of the reasons why I love talking about this topic.
First, let’s talk about the different types of UI. Stress urinary incontinence presents as accidental leakage associated with activities like sneezing, laughing, coughing, or jumping.
Urge incontinence (including overactive bladder) involves the sudden urge to urinate followed by involuntary loss of urine. Mixed incontinence is the combination of stress and urge incontinence. Stress urinary incontinence (SUI) is the most common form and is often caused by weakened pelvic floor muscles.
While one in three mothers report SUI within three months of childbirth, UI prevalence indisputably increases with age: 62 per cent of women in their 40s have UI compared to 68 per cent of women in their 50’s, 72 per cent in their 60s and 83 per cent in their 70s.
But does menopause cause incontinence? Yes and no.
Menopause is defined as the natural event of a woman’s final menstrual cycle. It is associated with reduced functioning of the ovaries due to ageing, resulting in lower levels of oestrogen, progesterone, and testosterone.
While these steep hormonal drops don’t directly cause incontinence, they cause thinning of the tissues in the pelvic floor muscles during perimenopause (the time around menopause when your ovaries gradually stop working).
Combine this thinning with common unresolved pelvic floor weakness or injury (e.g. caused by pregnancy, childbirth, pelvic surgery, falls) and/or with common changes associated with ageing (e.g. lowered fluid intake, lowered activity, constipation) – and urinary incontinence can result.
Stress urinary incontinence is most often caused by weak pelvic floor muscles – and menopause-related changes exacerbate that weakness.
Pelvital on-staff pelvic health doctors of physical therapy Shravya Kovela and Leah Fulker describe how this works in a blog on the menopause / incontinence connection: Weak pelvic floor muscles are unable to contract properly to close the urethral sphincter where urine escapes the body.
When paired with hormonal changes of menopause and the resulting changes in tissue flexibility or elasticity of the vulva, vagina, and urethral sphincter, urinary incontinence will appear or worsen.
Furthermore, discomfort in the vulva and vagina associated with menopause-related vaginal dryness or pain may lead pelvic floor muscles to compensate, worsening urinary incontinence.
Interestingly, menopause and ageing do not equally impact incontinence. Menopause transition has been found to correlate with stress urinary incontinence, whereas increasing age and risk factors such as anxiety, BMI, and new onset diabetes correlate with both stress and urge incontinence. And new onset of SUI is highest in perimenopause as opposed to postmenopause.
But the natural processes of menopause and ageing are not the biggest challenge women face when it comes to incontinence. The biggest challenges are the historic silence and assumption that our only options are pads or surgery.
Tragically, according to the Study of Women’s Health Across the Nation (SWAN) – a historic study to define menopause transition and “characterise its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women” – fewer than 40 per cent of incontinent women even seek treatment from their healthcare provider.
Women are uncomfortable bringing this topic up with their providers and when they do, too often are dismissed without options.
Menopause gaslighting is occurring to women because historically there has been a significant lack of clinically proven conservative options for women who do not wish to have surgery.
Pelvic floor physical therapy has been the shining light here, but a mere one per cent of physical therapists specialise in the pelvic floor, resulting in significant access gaps.
The continued uptick in virtual pelvic health physical therapy options is a big positive, increasing access and enabling women to fit treatment into their lives. Similarly, evidence-based in-home treatment options allow women flexibility and clinicians the ability to extend their clinic walls and deliver conservative care at scale, with outcomes very similar to surgery.
This conversation is incomplete without mention of economics and gender equity. Not only has research into women’s health been historically massively underfunded, but women bear disproportionate out-of-pocket costs.
Specific to UI, 70 per cent of costs are borne by the woman. And that is also completely unacceptable. I am proud to be part of the growing cohort of femtech companies creating change and step by step moving towards broad access and insurance coverage. Women deserve no less.
Lydia Zeller is CEO at Pelvital USA, Inc., a Minnesota based femtech company providing products to restore pelvic floor health. Flyte by Pevital is an FDA-cleared novel in-home treatment for female urinary incontinence.
Opinion
From platforms to people: The next era of femtech
By Katrina Zalcmane, head of partnerships and growth, Véa
The next era of femtech shifts focus from platforms to people as women rethink how technology fits into wellness and social life.
Women are spending less time on ambient, always-on digital environments and more time in bounded, intentional, in-person settings.
This is not a rejection of technology but a reprioritisation of how and where it belongs. For femtech, this shift is not cosmetic. It signals a structural change in user expectations – one that has implications for product design, engagement models and long-term relevance.
I explore three key signals underpinning this shift: reduced engagement with social media platforms, the resurgence of in-person, women-led communities and growing fatigue with fragmented digital tools.
Signal 1: Declining Engagement With Social Platforms Among Women
Multiple data sources point to a flattening or decline in engagement with traditional social media platforms, particularly among women:
- Pew Research Center reports that adults are increasingly “actively limiting” their social media use, with women more likely than men to cite emotional exhaustion and reduced wellbeing as reasons.
- Ofcom’s Online Nation report shows year-on-year declines in time spent on social platforms among UK women aged 25–44, alongside rising use of messaging and offline coordination tools.
- Meta itself has acknowledged a shift away from “social graph” engagement toward private, smaller-group interactions in recent earnings calls.
While this is not mass abandonment, it does indicate selective withdrawal: fewer platforms, less ambient presence, more intentional use.
Signal 2: The Rise of In-Person, Women-Led Communities
At the same time, participation in physical, community-based activities has increased. Examples include:
- the growth of women-led run clubs and fitness collectives across major cities, often operating independently of digital platforms;
- the expansion of paid, small-scale retreats and circles focused on reflection, creativity or embodiment;
- increased demand for local, recurring group experiences rather than one-off events.
While women are stepping back from social platforms, they are stepping into real-world communities. ONS data on social capital shows a post-pandemic rebound in in-person participation, particularly among women aged 25-45, with a preference for smaller, repeat gatherings over large social events.
What distinguishes this wave of community-building is intentionality. These spaces are bounded, often invitation-based and deliberately offline.
They are designed to counteract overstimulation rather than add to it.
Signal 3: Tool Fatigue and the Consolidation of Digital Habits
Alongside social media fatigue, there is growing evidence of “tool fatigue” across wellness and productivity categories:
- App retention rates across health and wellness remain low, with industry benchmarks showing that fewer than 25 per cent of users remain active after 30 days.
- Deloitte’s Digital Consumer Trends report notes a move toward app consolidation, with users preferring fewer, multi-purpose tools over fragmented stacks.
- Qualitative studies show women are particularly sensitive to cognitive overload caused by managing multiple apps for mood, cycles, health, reflection and social coordination*.
The implication is not that women want less support but that they want smarter, simpler tools that can actually help manage their inner lives.
What This Means: A Shift in the Role of Technology
Taken together, these signals point to a clear trend: technology is moving from being a primary site of social life to a supporting layer around it.
Women are not asking apps to become communities. They are asking them to:
- help them reflect and process privately;
- reduce cognitive and emotional clutter;
- support real-world relationships rather than replace them;
- operate in bounded, intentional ways.
This reframes success metrics. Engagement time and daily active use become less meaningful than whether a tool genuinely increases capacity, clarity and presence outside the app.
Implications for Femtech
For femtech, this marks a decisive transition. The first phase of femtech focused on visibility: tracking cycles, symptoms and bodily data that had previously been ignored.
The next phase will focus on integration: helping women make sense of experience in ways that support how they live, relate and gather.
Femtech products that attempt to:
- replicate community digitally,
- build social feeds under the banner of wellbeing,
- position AI as a substitute for real connection,
risk misaligning with where behaviour is actually moving.
By contrast, femtech that treats technology as infrastructure, not destination, is better positioned for longevity.
Where Véa Fits
Véa was built with this shift in mind.
Rather than attempting to replace connection or build another social layer, Véa focuses on internal processing – neuroscience-backed journaling, emotional pattern recognition and reflective AI support – so that women can show up more clearly in their real lives.
Importantly, Véa is not only a digital tool.
It is designed to extend into physical space, through curated in-person experiences and community gatherings that prioritise presence, embodiment and shared reflection.
The digital layer exists to support the human one, not compete with it. In a context of tool fatigue and selective disengagement, this hybrid model – digital support paired with real-world interaction – aligns closely with how women are choosing to engage today.
Over the next decade, the most resilient femtech products will not be those that maximise time spent inside ecosystems but those that give women back the capacity to return to their lives – with greater clarity, energy and real-world connection.
It’s time to design femtech that empowers presence over engagement.
*Reich-Stiebert, N., Froehlich, L. and Voltmer, J.-B. (2023). ‘Gendered mental labor: A systematic literature review on the cognitive dimension of unpaid work within the household and childcare’, Sex Roles, 88, pp. 475–494.
Opinion
How Women in Tech Switch Off Without Switching Off
Modern tech work blurs the boundary between focus and fatigue. Notifications spill into evenings, side projects jostle for attention, and the same screens we use to ship code stream our downtime. The answer is not to disconnect completely. It is to design small, protective rituals that restore energy while keeping a gentle sense of control. Short, low pressure restorative online play can sit alongside other evening habits without draining tomorrow’s focus.
Make Recovery a Feature, Not a Fix
Burnout rarely arrives in a single moment. It builds through micro stresses that never get cleared. Treat recovery as a product feature you ship every evening, simple and reliable rather than grand and rare. Start with boundaries that mark the end of the workday. Close the laptop, write a one line note about tomorrow’s first task, and put your kit out of sight. That single gesture creates a clean edge the brain respects.
Then change the environment. Shift lighting from cool to warm, swap the chair for the sofa, and set your phone to a calmer home screen. These cues matter. They tell your nervous system the mode has changed so you can mix mental rest with light engagement that still feels intentional.
Short, Screen-literate Rituals That Actually Work
- A ten minute mobility or stretch video resets posture after hours at a desk
- A tidy loop, like clearing the downloads folder or filing screenshots, reduces digital noise
- A breath guided practice that ends on the dot gives a measurable downshift
- A single chapter of a book or a short podcast episode keeps attention light and finite
When energy is low, aim for the smallest possible win. Two minutes of breathing still counts. One drawer tidied is still progress. Preserve the shape of recovery rather than chasing perfection.
Where Light Online Play Fits
Play is a human need, not a teenage phase. In the right dose it helps down regulate stress and restores a sense of agency after a day of reacting to tickets and pings. Keep it light and bounded. Choose modes that resolve in fifteen to twenty minutes, mute work apps, and set a visible stop time before you start. The aim is a calm, finite session that ends cleanly.
Cosy builders, puzzles, or narrative adventures often deliver novelty without social pressure. If you prefer something social, co-op rounds that finish quickly provide connection without dragging the night. Headphones with a gentle volume limit protect shared spaces and evening quiet.
Pair play with tiny chores so life runs smoother. Start a short download, fold laundry while it completes, then enjoy your round guilt free because the house already feels calmer. This is deliberate energy management, not indulgence.
Design a Space That Calms On Sight
- Put a warm lamp on a simple timer so evenings do not begin under harsh light
- Keep controllers, headphones, and chargers in one tray so play starts cleanly and puts away fast
- Use a standing phone dock during dinner to avoid reflex checks
- Keep the bedroom device light and cool in tone so your brain associates the space with sleep
If you live with others, make the evening rhythm visible. A shared quiet hours note, a soft household wind down alarm, and a last call for dishwashing help everyone respect the boundary between work and rest.
A Weeknight Template That Holds Under Pressure
- Shutdown: one line for tomorrow, close tabs, quick desk tidy
- Reset: ten to fifteen minutes to settle the kitchen and lay out morning basics
- Nourish: simple dinner that keeps cleanup minimal
- Reward: one short activity on a timer, with light online play as an option
- Wind down: warm lights, gentle stretch, phone on do not disturb, consistent lights out
If you miss a step, shrink it rather than skipping the whole routine. Small completions compound. Over a month they beat heroic bursts every time.
Leadership Starts With Example
Team norms shape personal wellbeing more than any tool. If you manage others, model sane hours and visible shutdowns. Delay send late emails, publish focus blocks, and praise outcomes over urgency theatre. Encourage short, restorative breaks through the day so evenings do not have to undo quite as much. When leaders normalise humane rhythms, teams follow and results improve because people are not running on fumes.
Wellness
Why period pain feels worse in winter
By Ruby Raut, founder and CEO, WUKA
If you have ever noticed that your cramps feel sharper, your mood dips harder, or your energy seems to disappear during the colder months, you are not imagining it. Winter can genuinely make periods feel more painful and more difficult to manage. The combination of cold weather, less sunlight, increased tension in the body, and reduced activity creates the perfect storm for stronger cramps and heavier emotional symptoms.
Understanding why this happens gives you the power to manage your cycle with more confidence. Here is the most digestible explanation of why winter and period pain are so closely linked.
Cold weather tightens blood vessels
When temperatures drop, your body goes into protection mode. To conserve heat, it tightens your blood vessels, especially around your hands, feet, and lower abdomen. While this is a smart survival response, it comes with an unwanted side effect for menstruation.
Your uterus is a muscle. Like any muscle, it needs good blood flow to relax and function smoothly. When the blood vessels around your pelvis tighten, circulation naturally becomes slower. Less blood flow means the uterus has to contract harder to shed its lining, and this can make cramps feel deeper, sharper, and more persistent.
This is why heat has always been one of the most effective comfort tools during a period. Warmth helps blood vessels open again, improves circulation, and relaxes the muscle of the uterus.
Your muscles tense up in the cold
Cold weather does more than chill your skin. It makes your whole body tighten without you even realising it. Think about how your shoulders creep upward when you step into the winter air or how your spine curls slightly for warmth. The same tension can build in your abdomen and pelvic floor.
Tighter muscles mean more resistance against the natural contractions of the uterus. When everything around the uterus is tense, cramps can feel more intense and more difficult to soothe. Even mild pain can feel magnified when the surrounding muscles are already stiff.
This is one of the reasons gentle movement, stretching, and warm baths can make such a difference during winter periods. Anything that eases tension also eases pain.
Less sunlight affects your mood and pain perception
Winter brings shorter days and longer nights, and that naturally reduces your exposure to sunlight. Sunlight plays a key role in regulating serotonin, the hormone that helps stabilise mood and influences how we experience pain.
Lower serotonin can lead to lower energy, stronger mood swings, and more emotional sensitivity. Because serotonin also impacts the way the brain processes discomfort, low levels can make cramps feel more intense.
This emotional shift can make PMS symptoms feel heavier too. Irritability, sadness, and bloating can all feel amplified during the colder months, creating a cycle that feels harder to manage.
Winter usually means less movement
Colder months naturally lead to less physical activity. We walk less, we spend more time indoors, and many people find it harder to stay motivated to exercise. While rest is important, the lack of movement has a direct impact on period pain.
Moving your body improves blood circulation and reduces inflammation. When you sit for longer or avoid movement due to cold weather, blood flow becomes slower and inflammation can rise. Both of these factors contribute to stronger cramps.
Even gentle activity makes a difference. A short stretch, a ten minute walk, or simple breathing exercises that open the chest and abdomen can support circulation and ease pain.
Prostaglandins may spike in colder weather
Prostaglandins are natural chemicals that help the uterus contract during menstruation. Higher levels are linked to stronger cramps and heavier flow. Some research suggests that colder temperatures and lower physical activity may increase the production of prostaglandins, although this varies from person to person.
This means that the natural winter slowdown combined with the physical effects of cold weather can lead to more intense uterine contractions, which again results in more painful periods.
How to make winter periods easier
The good news is that small, accessible habits can make a big difference to how your body feels during winter.
Use warmth generously
Heat patches, warm showers, hot water bottles and cosy clothing help open up blood vessels and soothe the uterine muscle.
Move your body even a little
Short walks, stretching routines or low impact workouts help improve circulation and reduce inflammation.
Support your mood with sunlight
Get outside during daylight hours whenever possible. Sitting near windows or using a light therapy lamp can also support serotonin levels.
Eat warming and nourishing foods
Soups, ginger, turmeric and herbal teas help comfort the body and may reduce inflammation.
Choose period products that keep you comfortable
Secure, breathable period underwear can help you feel more relaxed and confident, especially when your body already feels tense from the cold.
Winter does not have to mean more painful cycles.
With warmth, gentle movement, and an understanding of how your body responds to the season, you can navigate cold month periods with more comfort and control.
Find out more about WUKA at wuka.co.uk
-
Insight3 weeks agoDesigner perfumes recalled over banned chemical posing fertility risk
-
Features3 weeks agoWomen’s health enters a new era – the trends shaping femtech in 2026
-
Features3 weeks agoBest menopause apps and products for 2026
-
Insight1 week agoParents sue IVF clinic after delivering someone else’s baby
-
Ageing4 weeks ago‘Rejuvenated’ eggs raise hopes for improved IVF outcomes
-
Insight2 weeks agoWomen’s health could unlock US$100bn by 2030
-
Insight3 weeks agoHigher maternal blood pressure increases risk of pregnancy complications, study finds
-
Entrepreneur4 weeks agoXella Health closes US$3.7 million in pre-seed financing




