Bladder Leaks Aren’t Normal: My Pelvic Floor Surgery Story

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Bladder leaks after 40 can feel embarrassing, frustrating, and incredibly isolating. When hormone imbalance, stress incontinence, urge incontinence, and other bladder symptoms begin happening at the same time, you may find yourself planning workouts, errands, travel, and even social activities around the nearest bathroom.

For years, I managed my symptoms instead of fully addressing them. I wore panty liners, changed how I exercised, emptied my bladder before leaving the house, and tried to laugh off moments that were not actually funny.

I told myself this was probably part of having babies and getting older.

But bladder leaks are not something we should automatically accept as normal after 40. In this very personal episode of The Menopause Makeover Podcast, I shared my experience five days after pelvic floor reconstruction and bladder sling surgery.

I want to talk honestly about hormone imbalance, incontinence and treatment, pelvic organ prolapse, surgery, and recovery because these are real issues women face. Yet so many of us do not discuss them until another woman is brave enough to say, “This happened to me too.”

This is my personal story and not medical advice. Every woman’s situation is different, so please talk with a qualified healthcare provider about your symptoms and the treatment options that may be appropriate for you.

When Bladder Leaks After 40 Begin Controlling Your Life

My bladder problems did not begin with one dramatic event. They developed gradually after the birth of my last baby, whom I had at age 44.

I had carried ten babies and have nine children here on earth. My body had done something remarkable, and I will always be grateful for that.

At the same time, pregnancy, childbirth, pressure on the pelvic floor, hormone changes, and the passing of time had affected the muscles and connective tissues supporting my bladder, uterus, vagina, and rectum.

Stress incontinence was one of my first noticeable symptoms. This is the type of leakage that may happen when you cough, sneeze, laugh, run, jump, lift, or perform another activity that increases pressure on the bladder.

For me, it became harder to jog or do higher-intensity exercise without leaking. I also began to feel pressure and heaviness in my pelvic area.

The best way I could describe it was that my bottom felt heavy. It sometimes felt as though everything was beginning to fall out.

At first, the symptoms felt manageable. I could wear a panty liner, modify certain movements, and keep going.

That is what so many active women do. We become experts at adapting, but sometimes we adapt so well that we fail to recognize how much of our lives are being rearranged around a health problem.

Over time, I was no longer dealing with stress incontinence alone. I also began experiencing urgency.

Urgency felt like suddenly needing to urinate and not being sure I could make it to the bathroom. There were times when I started leaking as soon as I got close to the toilet.

There were also times when I completely urinated on myself before I could get there.

These urge incontinence and bladder symptoms were no longer a small inconvenience. They were affecting my exercise, clothing choices, confidence, intimacy, and quality of life.

Can Hormone Imbalance Make Incontinence Worse?

Many women begin noticing changes in their bladder, vagina, and pelvic floor during perimenopause and menopause. Hormones may be part of the picture, but they are not always the only cause.

As estrogen changes, the tissues around the vagina, bladder, and urethra can also change. Some women notice more urinary urgency, frequency, dryness, discomfort, irritation, or recurring bladder symptoms.

In my case, hormone imbalance was one piece of a much larger story.

I had multiple pregnancies and births, many years of high activity, and structural changes in the support of my pelvic organs. I eventually learned that I had uterine prolapse, a rectocele, and significant bladder leakage.

A prolapse happens when weakened muscles and tissues are no longer fully supporting one or more of the pelvic organs. A rectocele occurs when the wall between the rectum and vagina weakens, allowing the rectum to press into the vaginal wall.

That can cause pressure, heaviness, difficulty with bowel movements, and the sensation that something is falling or bulging.

This is why it is important not to assume every bladder symptom is caused by hormone imbalance alone. Hormones can matter, but muscular, structural, medical, and lifestyle factors may also be involved.

You deserve a complete evaluation—not just another panty liner.

Looking back, I also wish someone had talked with me more about pelvic floor physical therapy when my symptoms first began. I am almost always going to choose therapy and more conservative options first when they are appropriate.

I had received pelvic floor therapy at one point, but it was focused on a different problem and did not address the symptoms I was experiencing. I also tried a vaginal laser treatment that helped temporarily, but the improvement did not last.

There are several possible approaches to incontinence and treatment. Depending on the cause and severity, a woman might be offered pelvic floor physical therapy, bladder training, lifestyle changes, medication, hormone-related treatment, a supportive device, surgery, or a combination of options.

Surgery is not automatically the first or best choice for every woman. For a long time, it was not the right choice for me because I was not emotionally or practically ready for the recovery.

But eventually, the symptoms progressed enough that I knew I could no longer keep managing them the same way.

Why I Finally Sought Treatment for Bladder Leaks

My turning point came while I was playing pickleball.

At the time, I was also dealing with prolonged breakthrough bleeding while my healthcare team and I worked through changes in my hormone plan. My body is very sensitive to missed or changed hormone doses, and I had experienced bleeding for about 60 days.

One day, between the bleeding and the urine leakage, I had to stop playing and change my clothes. I got into my car and cried.

I was tired of dealing with it.

I had worked hard to support my hormones, heal from a glute and hamstring injury, rebuild my strength, and remain active. Now I was facing another physical challenge that felt as though it was taking away part of the active life I loved.

I had moments of thinking, “Why is this happening to me?”

I probably had a little fit here and there too.

But staying in that thought was not going to move me forward. Eventually, I began thanking God for my body instead.

I thanked Him for allowing me to carry my babies, raise my children, heal from injuries, move through perimenopause and menopause, and continue doing meaningful work.

Psalm 139:14 tells us that we are fearfully and wonderfully made. That does not mean our bodies will never experience weakness, pain, injury, or change.

It means our bodies are still worthy of care.

Seeking answers was not rejecting my body. It was one way of honoring the body God had given me.

My husband and I prayed about the situation, and we both felt that my next step was to schedule a consultation. I was not agreeing to surgery at that point.

I was simply agreeing to gather information.

A trusted friend had already gone through a similar surgery and had a good experience with Dr. Michael Litrel in Atlanta. Because I live outside Nashville, traveling to Atlanta was not the most convenient option, but I wanted to see a doctor who regularly treated these kinds of pelvic floor conditions.

After an examination, ultrasound, bladder testing, and additional medical care, I learned that I had uterine prolapse, a rectocele, and significant bladder leakage.

During my bladder testing, I learned that I was leaking about 250 cubic centimeters of urine. My doctor explained that this was approximately half of a soda can.

That information validated what I had been experiencing. I was not overreacting or simply being a wimp.

There was a significant physical problem.

Based on my individual evaluation, Dr. Litrel recommended pelvic floor reconstruction and a bladder sling. I did not need a hysterectomy, which was important to me because I only wanted to have the procedures that were medically necessary.

A bladder sling provides additional support around the urethra to help reduce urine leakage when pressure increases from coughing, sneezing, exercising, or lifting.

My treatment will not be the right treatment for every woman. Your symptoms, medical history, examination, goals, and response to conservative care all matter.

But getting evaluated gave me clarity. Once I understood what was happening inside my body, I could make a thoughtful decision rather than continuing to guess.

My Pelvic Floor Surgery and Early Recovery

My surgery lasted about two and a half hours. The procedure involved repairing the prolapse, restoring pelvic support, addressing the rectocele, tightening the affected tissues, and placing the bladder sling.

The early recovery was more painful than I expected, even though I knew it would be significant.

Urinating was difficult at first. Bowel movements also required careful management because constipation and straining were the last things I needed while healing from internal and external stitches.

I followed my surgeon’s instructions, used the medications and stool softeners recommended by my medical team, rested, and communicated with my doctor when something did not feel right.

My husband and children were very supportive, and a few friends brought meals. I did not want many visitors because I was uncomfortable and needed space to rest.

There were moments of acute pain when I wondered whether everything was okay. My doctor checked in with me regularly, and I also had women who had been through similar procedures reassuring me about what they had experienced.

That support was incredibly valuable.

Doctors and nurses can explain the medical details, but sometimes you also need a woman who has been there to say, “Yes, I experienced that too,” or, “Call your doctor about that.”

Five days after surgery, I was beginning to reduce my prescription pain medication during the day. I was still using pain support at night, waking frequently, and feeling a great deal of pressure.

Every day brought something new, but every day also brought a little progress.

Recovery is not a straight line, and it cannot be rushed.

My doctor instructed me to limit my activity and avoid heavy lifting during the initial recovery. At that stage, I was taking only three-to-five-minute walks and doing a little gentle upper-body band work while seated or reclined.

As a personal trainer, I know how tempting it can be to do too much too soon. We feel one good day and immediately want to prove we are back.

But healing is also training.

Resting when your tissues need rest is not laziness. Following your medical restrictions is not weakness.

Beginning again slowly can protect the progress your body is working so hard to make.

Protein, Essential Amino Acids, and My Recovery Shake

Nutrition has also been an important part of my recovery.

Because I am at my goal weight, my focus during this season is maintaining muscle, supporting tissue repair, and giving my body what it needs to heal well. I am not trying to force my body back into my usual routine before it is ready.

Protein remains a priority because the body uses amino acids to repair and rebuild tissue. I normally eat plenty of protein as part of my Trim Healthy lifestyle, but during recovery I have been even more intentional.

Along with protein-rich meals, I have been using an additional serving of Trim Healthy Essential Pure Amino Acid Formula.

At the time I recorded the episode, I was having two servings of essential amino acids during the day, one serving of Optimized Protein Powder mixed with almond milk, and the protein included in my regular meals.

Essential amino acids are amino acids that our bodies cannot make on their own, so we must receive them through food or supplementation. For me, they have been a simple way to support my protein intake when pain, limited movement, and recovery have made my normal routine look different.

I am simply sharing what I chose to use during my own recovery. Always ask your healthcare provider about new supplements, especially if you take medication or are recovering from surgery.

I have also been drinking the Trim Healthy Mama Best Recovery Shake daily.

This pineapple-based shake includes ingredients such as protein powder, vitamin C, and flaxseed. In my version, I have been using kefir and vanilla protein powder to make it creamy, increase the protein, and add a little sweetness.

It has been an easy way to nourish myself when I do not feel like standing in the kitchen or preparing a larger meal. It is not a magical shake, but it is a practical tool that helps me stay consistent while my appetite, movement, and schedule are different.

My goal is to heal well, maintain as much muscle as possible, and gradually return to walking, lifting, and pickleball when my doctor clears me.

That return will require patience.

I will not immediately jump back into the weights and intensity I used before surgery. I will rebuild slowly with walking, bands, body-weight movements, and progressive resistance.

That is not starting over.

It is meeting my body where it is and allowing strength to be rebuilt wisely.

You Deserve Answers for Incontinence and Bladder Symptoms

Bladder leakage may be common in midlife women, but common does not mean you have to ignore it.

Please talk with a qualified healthcare professional if you are experiencing leaking, sudden urgency, trouble emptying your bladder, pelvic pain, pressure, heaviness, recurring infections, difficulty with bowel movements, or the feeling that something is falling or bulging.

Your solution may look very different from mine.

You may benefit from pelvic floor physical therapy, hormone-related treatment, bladder training, medication, supportive devices, surgery, or another approach based on your individual diagnosis.

The goal is not to copy another woman’s treatment. The goal is to realize that you are allowed to ask for help.

I know these symptoms can feel too personal to discuss. Yet every time I share openly, another woman says, “Me too. I thought I was the only one.”

That is why I recorded this episode from my bed five days after surgery with an iced water bottle between my legs. It was not glamorous, polished, or comfortable, but it was real.

I want women to understand what can happen after pregnancy, childbirth, hormone changes, perimenopause, and menopause. I also want you to know that support and treatment options are available.

Most importantly, you are not alone.

God is present in this part of your story too. He is with you as you ask uncomfortable questions, make wise decisions, recover, rebuild, and learn how to care for the body He has given you.

Midlife does not have to mean giving up the activities you love. You may need support, treatment, modifications, or time to rebuild, but you can continue becoming a fit, strong woman in this season.

Ready to get rid of stubborn belly fat, build lasting muscle, and feel stronger and more confident in your midlife body? Join me inside the Belly Fat Breakthrough Tribe, where we use simple Trim Healthy principles, realistic movement, coaching, and faith-filled mindset support to help women over 40 move forward without starting over every Monday.