If you laughed really hard at a joke recently and felt a little urine escape, you aren’t alone. While it can be uncomfortable to talk about, incontinence is common—and treatable.
In fact, incontinence, which is the loss of bladder control, affects millions of Americans to some degree. While the condition can occur in both men and women, it’s especially common among women, particularly as they get older.
“Bladder leakage affects twice as many women as men,” says Don Wilson, MD, gynecologist and women’s health specialist with West Tennessee Medical Group GYN Specialists. “That’s because women go through stages of life, including pregnancy, childbirth and menopause, that can all make incontinence more likely. The good news is that incontinence can be treated, and in many cases, prevented.”
The 411 on Incontinence
As we mentioned above, incontinence is the loss of bladder control. In other words, it’s when urine leaks out on accident.
When the urinary system is functioning normally, urine is made in the kidneys and then stored in the bladder. The bladder is sometimes described as a small “sac,” and it’s about the size of a pear when it’s empty.
As your bladder fills with urine, its muscular lining stretches. When you urinate, those same muscles squeeze, and small valves called sphincters open up to allow urine to escape. Urine moves from the bladder into the ureter, which carries it out of the body.
In some cases, those muscles may suddenly tighten and the sphincters may not be strong enough to keep the ureter shut. This creates a strong urge to urinate that’s often uncontrollable, leading to leakage. This type of bladder leakage is known as urge incontinence.
Incontinence can also sometimes occur due to pressure on the bladder caused by normal activities, like laughing or sneezing. This type of leakage is known as stress incontinence.
Along with urge and stress incontinence, there can be other causes of bladder leakage, such as overflow incontinence (when the bladder doesn’t fully empty), functional incontinence (when a disability of some type keeps you from getting to the toilet in time), transient incontinence (which is associated with a temporary issue such as a medication), or mixed incontinence (which means you have multiple types of leakage).
The Causes of Incontinence
So, knowing how the body normally functions, what exactly causes incontinence? Essentially, it’s a combination of factors that all somehow impact the muscles and nerves around the bladder. Causes of bladder leakage can include:
- Being overweight or obese. Excess weight puts pressure on the bladder and can weaken the bladder and sphincter muscles over time.
- Having constipation. Straining to have a bowel movement can put stress on the bladder and the pelvic floor muscles.
- Having nerve damage. Damaged nerves can send erroneous messages to the bladder, signaling the need to urinate when not necessary or not signaling it at all. Nerve damage is common during pregnancy and childbirth, as well as with conditions such as diabetes or multiple sclerosis.
- Having surgery. Certain types of surgery involving the female reproductive organs can damage the pelvic floor muscles, which can cause the bladder to not work effectively.
In addition to long-lasting causes of urinary incontinence, bladder leakage can also occur due to temporary factors, such as an infection, excessive caffeine intake, or the use of some medications.
Preventing & Treating Incontinence
If you’re experiencing bladder leakage of any sort, talk with your medical provider. You don’t have to simply live with leakage; there are solutions available that can help.
In many cases, you can take steps at home to both stop incontinence and prevent it from happening in the future. This can include some basic healthy lifestyle habits, such as losing weight and quitting smoking, along with incorporating other habits that will benefit your bladder.
If you frequently experience bladder leakage, for example, you may benefit from reducing your intake of caffeine or carbonation, which can both worsen incontinence.
You can also do some basic exercises to help treat incontinence. If you experience stress incontinence, where things like sneezing can trigger a leak, Kegel exercises may help. These basic exercises help strengthen the pelvic floor muscles. For urge incontinence, you may be able to “train” your bladder by gradually increasing the amount of time between bathroom visits.
Bladder leakage is especially common among women during and following pregnancy. Childbirth can weaken the pelvic floor muscles and damage the nerves around the bladder.
If you’re experiencing leakage during or after pregnancy or after menopause, work with your medical provider and a pelvic floor specialist to determine a treatment plan that will work best for your needs.
“I have learned from a physical therapy standpoint that we need to look at pregnancy and delivery more like an injury,” says Megan Meyer Stovall, PT, DPT, MDT Cert, pregnancy and postpartum exercise specialist at Sports Plus Rehab. “Our current culture places an enormous amount of stress on moms to ‘bounce back.’ But even after a normal delivery, things have been stretched, stressed and strained—and need time to recover.”