Bladder Leakage? 3 Things Women Should Know About Urinary Incontinence
To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.
Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.
And they’re not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Woman’s Hospital at Michigan Medicine.
She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isn’t just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.
But if so many women experience it, then why does the topic still seem embarrassing?
“Women get the sense that this is inevitable, that it’s a natural part of aging and they have to live with it,” says Fairchild. “This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.”
To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.
1. There are different types.
If you experience incontinence when you sneeze, cough, or exercise, you may have stress incontinence, which is leakage from added pressure on the abdomen that pushes urine past the urethra.
If you stand up and are unable to hold off on emptying your bladder before you reach the bathroom, you may have urge incontinence, otherwise known as an overactive bladder.
Many women have a combination of stress and urge incontinence called mixed incontinence. And although less likely, some women experience overflow, a rare condition which causes frequent urinary leaks due to a constant full bladder.
2. It could be a sign of an underlying condition.
Naturally, later in life, people can experience incontinence because of increased production of urine related to aging kidneys. Bladder function is also heavily impacted by changing bladder capacity and chronic medical conditions like diabetes, says Fairchild. Chronic straining, coughing and/or constipation can all put stress on the bladder, she explains.
But leakage can also be sign of a more serious, underlying health condition, according to a 2018 National Poll on Healthy Aging." For example, poor heart function could be the culprit behind frequent urination while sleeping.
“If fluid is pooling in your legs during the day, when you lay down, that fluid redistributes and increases urine production,” says Fairchild.
Although bladder leakage is common, discuss your particular symptoms with your doctor.
3. Treatment options exist.
And they’re not all invasive or surgical.
Small behavioral changes, like bladder training, eating more fiber to reduce constipation, decreasing the amount of fluids you drink, or cutting out bladder irritants such as artificial sweeteners and caffeine, can all help improve symptoms.
“For someone who feels like they aren’t emptying well after going to the bathroom, it may be a simple fix like standing up after urinating and sitting back down to try and empty again,” says Fairchild.
If bladder leakage is causing discomfort or distress, Kegel exercises, either at home or with a physical therapist, can help isolate the pelvic floor muscles and make them stronger, aiding in controlling urine flow. Seeing a pelvic floor physical therapist is beneficial for many women, because often even when women sense that they are performing exercises correctly, up to a quarter of them are not activating the muscles effectively.
Sessions with a therapist may involve intravaginal intervention, which involves checking that the right muscles are being squeezed at the right time. This may be especially helpful to a woman who has just given birth.
More invasive measures include options like Botox injections which treat urgency incontinence or a sling procedure aimed at treating stress urinary incontinence. Botox, which has been used for urinary incontinence for over 10 years, is injected into the wall of the bladder to help it relax since spasms can also cause incontinence.
With the sling procedure, a sling is placed under the urethra to stop incontinence that occurs with increased abdominal pressure activities like jumping, running, and coughing. The technique can be done same day, using synthetic material or your own tissue that is inserted through the vaginal opening or through a small incision in the abdomen, according to Fairchild.
If you still feel lost about living with urinary incontinence, a physician can help create a treatment plan best suited to your preferences and lifestyle.
“Remember, this is such a common condition. You’re not alone,” says Fairchild. “Make an appointment with a doctor and see what your options are. No one should put their life on hold because of urinary incontinence.”
For more information on urinary incontinence and other pelvic floor disorders, check out our livestream here.