Leaking, Urgency and Pelvic Floor Decline After 40: What Your Doctor Is Not Telling You

Are you dealing with bladder urgency, urinary incontinence, or painful sex in your 40s? You are not alone. In this episode of The Forties Formula, we dive deep into pelvic floor dysfunction—the invisible health crisis affecting women in perimenopause and beyond. Most women prepare for wrinkles and hot flashes, but few are taught about pelvic health. We sit down with PREET SINGH, a pelvic health physiotherapist, to discuss the symptoms women rarely talk about: leaking when sneezing, constipation, and changes in sexual health. We break down why kegel exercises aren't always the answer and explore real treatments like pelvic physio and vaginal estrogen. Listen to understand pelvic floor health without stigma, and women’s health in midlife without outdated assumptions. --------- CHAPTERS 00:00 – Episode Snippet 00:55 – Introducing our guest, Preet Singh 01:40 – Why pelvic health is not widely discussed 05:56 – What pelvic health does and doesn’t cover 09:12 — Incontinence happens without childbirth 10:38 — Pregnancy itself is a risk facto 12:09 – Advertisement: Love, Indus 13:43 – Episiotomy use and outcomes 16:39 – BMI, lifting and respiratory health 19:01 — Correct bowel posture reduces strain 23:06 —Is holding your pee bad for your pelvic floor? 25:29 — Fuel Your Forties: How does food impact your pelvic health? 27:21 — Perimenopause alters hormones first 30:25 — Bladder changes in perimenopause 32:40 — Vaginal estrogen is first-line care 33:24 — Belly changes aren’t always “weight” 35:17 — Accumulated habits show up in your 40s 36:00 – Advertisement: Cozy Earth 37:06 — Hot or Hype Segment 40:17 — What a pelvic floor exam includes 42:56 — Ultrasound helps but has limits 44:14 – Treatment options extend far beyond Kegels 45:27 — Stress and arousal affect painful sex 47:58 – The 40s Formula: Protect time, energy and boundaries in midlife Links & Resources: Toilet Meditation: A.I.R.B.A.G. with Shelly Prosko and Amy Wheeler Special Thanks to Our Sponsors: 🥩 The Meat Club – Get $20 off with code TFF20 🛏️ Cozy Earth – Sleep comfortably with soft bamboo sheets and cozy pajamas. Use code TFF for 41% off. Free shipping in Singapore over $560 and in the US over $50. ❤️ Love, Indus: Get 21% off luxury skincare with code TFF ______________ Stay Connected: 📩 Join our mailing list for exclusive content, our weekly Forty Tude newsletter, expert tips, and early access to giveaways! 📘Free Guide — The Forties Formula Ebook: Your simple, honest guide to what’s changing in your 40s — hormones, cravings, energy, strength and more.