Post-menopausal atrophic changes in genital tissues due to lack of oestrogen can cause the vaginal epithelium to become inflamed, contributing to urinary symptoms such as frequency, urgency, dysuria, incontinence, and/or recurrent infections. Atrophy in periurethral tissues can contribute to pelvic laxity and stress incontinence and changes in vaginal pH and vaginal flora may predispose post-menopausal women to urinary tract infection. This is therefore a possible transient cause of Mrs Scott’s incontinence.