Urinary incontinence refers to the loss of bladder control and is a very common problem. Unfortunately, it is also a very embarrassing problem for many women, and so they often just live with it rather than discussing it with their doctors – which is too bad, because there are effective treatments available, and some of them are very simple.

Urinary incontinence can be mild or severe, ranging from the occasional leak upon sneezing or coughing to having such strong, sudden urges to urinate that you can’t make it to the toilet in time. If incontinence is affecting your day to day activities, please don’t hesitate to talk to your doctor about it. He or she has heard it before, and some simple medical treatment or even just lifestyle changes in some cases can make a huge difference. There are several different types of urinary incontinence, for example:

Stress Incontinence: Leaking urine when pressure is exerted on the bladder, such as through laughing, sneezing, coughing, or heavy lifting. Childbirth and menopause often result in stress incontinence. Obesity is a very common culprit.

Urge Incontinence: An intense and sudden need to urinate. Women with this type of incontinence often experience involuntary loss of urine and “not making it” to the toilet in time. The bladder contracts and in some cases the woman has only a matter of seconds to reach a restroom. This type of incontinence can be caused by a variety of health problems such as UTIs (urinary tract infections), stroke, Parkinson’s or Alzheimer’s disease, and multiple sclerosis. 

Overflow Incontinence: Women who have trouble emptying their bladders completely may experience overflow incontinence, or the frequent or constant leaking of urine. A women with this type of incontinence may not be able to empty her bladder and may be able to produce only a weak stream of urine; typically, this is caused by some type of damage to the bladder – for example, nerve damage caused by multiple sclerosis or diabetes.

There are also cases where women experience more than one type of incontinence. To be sure, it can feel embarrassing to tell your doctor you are having a problem with incontinence. But this is a much better option than suffering in silence. For starters, incontinence may be a symptom of a more serious problem. It can also seriously affect your quality of life, especially if you are restricting your activities and limiting social interactions.

What Causes Urinary Incontinence?

Incontinence can be temporary or permanent, mild or severe. It can be caused by a number of different things. Sometimes, temporary incontinence or isolated incidents can be caused by alcohol, caffeine, or over-hydration; it can also be caused by a UTI and in this case, it goes away as soon as the infection is treated.

When incontinence is persistent, it may be caused by an underlying physical condition or problem, such as an undiagnosed urinary tract infection , pregnancy, hysterectomy, neurological disorders, or obstruction of the urinary tract by a stone or tumor.  The most common reason is just aging and not pregnancy or the mode of delivery.   As stated here back in May, nuns have the same prevalence of urinary incontinence as mothers.

See Your Doctor for a Solution

Often, women with urinary incontinence are most comfortable talking to their gynecologists first. In most cases, your gynecologist can help you with this problem; in certain cases, he or she may need to refer you to a urogynecologist or other specialist. When you go to your appointment to discuss your problem, be prepared with some information that your doctor is sure to ask you for. For example, your symptoms in detail and a list of all medications you take (including vitamins). Also write down questions you have so you don’t forget them once you are in the doctor’s office.

The type of treatment recommended will depend on your individual symptoms and the type of incontinence you are experiencing. Your doctor will most likely suggest the least invasive treatments first, and often, these are quite effective. He or she may suggest that you try certain techniques such as bladder training, double voiding, diet and fluid management, or Kegel exercises.

If these are not effective, there are medications available that can help. There are also medical devices such as urethral inserts and pessaries that can be helpful. Sometimes, urinary continence may require surgical treatment.

To reduce your risk of developing urinary incontinence or to prevent yours from worsening, maintain a healthy weight, do regular Kegel exercises, don’t smoke, and avoid foods known to irritate the bladder such as caffeine and alcohol. You will almost certainly be glad that you talked to your doctor about your incontinence. Go make your appointment now and you’ll be one step closer to relief.

– Yvonne S. Thornton, M. D., M. P. H.