Common Weak Bladder Causes

You may think a weak bladder causes bladder leakage or incontinence but, in fact, as many Pelvic Health physiotherapists will tell you, you don’t actually have a weak bladder but you may have weak Pelvic Floor muscles.

If you’ve started to avoid wearing lighter coloured clothes, always carry a big handbag with a change of clothes around with you or experience ‘Key in the door syndrome’ where you absolutely have to go the toilet as soon as you reach home, you may be experiencing bladder leakage caused by weak Pelvic Floor muscles.

Don’t worry, you are not alone! One in three women experience bladder leakage 1 and two out of three women over 40 are affected. That’s a lot of us women but, the good news is, you can strengthen your Pelvic Floor and treat bladder leakage so you’re able to wear your favourite pale clothes again or last longer before needing the toilet.


Bladder leakage means that you pass urine when you don’t mean to. It can range from a small dribble now and then, to large floods of urine. The medical term for bladder leakage is ‘urinary incontinence’. Leaks may be occasional or frequent depending on the severity and type of condition.

In a recent poll of 2,000 women over 40, nine out of 10 sufferers said bladder leakage had a ‘major impact’ on their quality of life. 70% claimed to have suffered bladder leaks when they laughed, coughed or sneezed with one in three have experienced symptoms when running, jumping or engaging in other physical activities2.


There are three different types of leakage:

  1. Stress leakage. This is when urine leaks at times when your bladder is under pressure; for example as a result of exercise or when you laugh, cough or sneeze. Women will often notice this for the first time when they jump on a trampoline with their children.
  2. Urgency leakage. This is when urine leaks as you feel a sudden intense urge to urinate but can’t reach the toilet in time – it can happen to anyone at any age but is more common in women during and after the menopause.
  3. Mixed bladder leakage. This is when both stress and urgency leakage are present.


The most frequent cause of bladder leakage in women is Pelvic Floor muscle weakness. The Pelvic Floor is a set of muscles that sit like a hammock between your tail bone (coccyx) and pubic bone and give control over our bladder and bowel. Weakened Pelvic Floor muscles in women may mean the bladder is not fully supported, leading to bladder leakage.

The most common causes of weak Pelvic Floor muscles are pregnancy and childbirth, menopause, chronic straining and surgery.

Pregnancy and Childbirth.

During pregnancy, hormonal changes and increasing weight of both the mum-to-be and baby can put a lot of stress on Pelvic Floor muscles from as early as 12 weeks. Childbirth can also have a further weakening effect especially if you have a large baby over 9lbs/4 kg, you push for a long time, have a forceps or ventouse delivery. Women who have a caesarean section delivery are also at risk due to the weight-gain and hormonal changes during pregnancy. 


The bladder is sensitive to the hormone oestrogen which is responsible for maintaining the elasticity of the supportive structures in the female pelvis. As you go through the menopause, your ovaries will gradually produce less oestrogen which causes Pelvic Floor muscles to weaken and reduce support for the bladder causing the sensitive nerves at the base of the bladder to send more frequent signals to the brain that we need the toilet. Lower levels of oestrogen can also cause symptoms like dryness, itching and irritation in the vagina and bladder. These changes can cause you to go the toilet more frequently including having to get up at night to empty your bladder (nocturia).

Chronic Straining 

Chronic coughing or chronic straining due to constipation can lead to unnecessary pressure on your Pelvic Floor weakening your muscles.


Some women experience bladder leakage following abdominal surgery for example after a hysterectomy, bladder or bowel surgery. It’s important to exercise your Pelvic Floor muscles after having any abdominal surgery in accordance with advice from your healthcare professional.

Being overweight, repeated lifting of heavy objects or high impact exercises can also overload your Pelvic Floor.


The NHS recommends Pelvic Floor muscle exercises (sometimes called Kegel exercises) to help improve bladder leakage. It’s important to develop a regular Pelvic Floor exercise regime as an adult but particularly after having pregnancy and childbirth. Many women build them into their daily routine, doing them first thing in the morning, during the TV ad breaks, when brushing their teeth or after a fitness workout. Learn how to locate your Pelvic Floor muscles and how to do them correctly here.

In our recent survey, 96% of women have heard of Pelvic Floor exercises but only 10% do them regularly2. In fact, clinical evidence suggests that as many as, 50% of women are not doing their exercises correctly in any case3 4. Through no fault of their own, many women simply do not have a good connection to their Pelvic Floor or they have very weak muscles that are hard to find.2

This is where a Pelvic Floor trainer like Pelviva ®can help to strengthen Pelvic Floor muscles and treat bladder leakage. Pelviva mimics the way the body works naturally effectively doing your Pelvic Floor exercises for you, sending pulses to the muscles and re-training them how to contract as they should. Pelviva also helps you recognise the feeling of doing Pelvic Floor muscle exercises correctly.

In a clinical study, 84% of women using Pelviva for 12-weeks reported improved bladder control and found it easy-to-use, reporting no side-effects.5

Furthermore, in a separate market research study, 80% of women using Pelviva reported significant improvements after three weeks usage (9 Pelviva), such as renewed confidence, longer time between loo breaks, more sleep due to not needing to get up multiple times in the night, and the ability to try new forms of exercise. Some women who use Pelviva have told us that they have been able to stop using incontinence pads and no longer need to change their clothes on a regular basis due to leakage.6

Find out further information at and for more information on other types of bladder conditions visit, Bladder and Bowel UK.

PEL/00143/UK  30.4.20


  1. Hunskaar S, Lose G, Sykes D, Voss S. The prevalence of urinary incontinence in women in four European countries. BJU Int. 2004 Feb;93(3):324-30.
  2. Femeda data on file. Survey of 2000 women over 40. Aug 2019
  3. ø K., Larsen S., Oseid S. et al. (1988) Knowledge about and ability to correct pelvic floor muscle exercises in women with stress urinary incontinence. Neurology and Urodynamics. 69, 261-262.
  4. Bump R.C., Hunt W.G., Fantl J.A., Wyman J.F. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American Journal of Obstetrics and Gynaecology. 165, 322- 329.
  5. Oldham J, Herbert J, McBride K. Evaluation of a new disposable ‘tampon-like’ electrostimulation technology (Pelviva®) for the treatment of urinary incontinence in women: a 12-week single blind randomized controlled trial. Neurourology Urodynamics 2013; 32(5):460-466. doi 10.1002/nau.22326.
  6. Kirk Research 2019
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