In women, stress incontinence (involuntary loss of urine during physical activity such as sneezing or exercise) is usually caused by a weakening of the bladder sphincter and pelvic floor muscles. Shrinkage (atrophy) of tissues where the bladder and urethra meet also contributes to the problem. Hormonal changes occurring after menopause are thought to be an underlying cause of these anatomical changes in the bladder sphincter that lead to urinary incontinence.
In postmenopausal women, decreased androgen (testosterone) levels weaken the pelvic floor and sphincter muscles, while an estrogen deficit induces atrophy of the urethra.
Mainstream medicine offers only mediocre therapies to address urinary incontinence. Drugs commonly used for this condition are expensive and side-effect-prone. Only a small proportion of the affected population seeks treatment because most people consider their urinary symptoms a consequence of normal aging.