Do you cross your legs when you feel a sneeze coming on? Do sudden urges to go cause you to panic? Do leaks just happen randomly, without notice? These are all symptoms of a condition known as urinary incontinence, or UI.

It’s estimated that about half of adult women experience UI. Yet of those who live with the symptoms, less than half seek care. Common reasons for delaying treatment for UI vary from embarrassment to fear of surgery to lack of awareness about non-surgical treatment options.

Below you’ll find a brief overview of the types of UI in women and their causes. You’ll also learn how we diagnose UI. Finally, we’ll cover non-surgical, medicinal and surgical treatments for UI.

Types of urinary incontinence

Each form of UI comes with distinct symptoms. Here are the different kinds of UI and the symptoms they’re known for:

  • Stress incontinence – Refers to any physical stress on the abdomen or bladder that forces urine to escape. This could be from laughing, sneezing, lifting heavy things or performing certain physical activities. Stress incontinence tends to be more common in younger women.
  • Urge incontinence – Happens when you feel a strong, persistent urge to urinate. This type of UI is caused by bladder contractions that expel urine, and is commonly referred to as having an overactive bladder. Urge incontinence tends to be more common in women’s later years although can also occur in younger women, too.
  • Mixed Incontinence – Refers to the presence of stress and urge incontinence. Most women who have urinary incontinence have a component of both stress and urge.
  • Overflow incontinence – Results from bladder overflow. When your bladder becomes too full, urine will then leak out. This can be either from not being able to fully empty your bladder during urination, or just not realizing you need to go. With this kind of UI, your leak may be continuous.

Causes

While the causes of UI are based on many factors, women are twice as likely as men to experience UI because of body structure. A healthy man’s urinary system will stay relatively the same throughout his life however a woman’s is built to be more flexible. It’s this flexibility that enables women to bear children but also leaves the urinary system more susceptible to weakening – even in women who never become pregnant.

Other factors that can increase the risk of developing urinary incontinence in women include:

  • Pregnancy and delivery
  • Aging
  • Obesity
  • Weakened pelvic floor muscles
  • Pelvic organ prolapse
  • Alcohol and caffeine consumption
  • Excessive fluid intake
  • Some medications
  • Menopause
  • Neurological conditions such as Alzheimer’s disease
  • Urinary tract infections (UTIs)

When to see a doctor for urinary incontinence

In most cases, UI can be treated without surgery. If left untreated, UI can lead to sleep loss, depression, anxiety and loss of interest in sex. It might be a good idea to see your doctor if your condition is causing you to:

  • Frequently urinate (8 or more times per day)
  • Feel tired from incontinence-related sleep loss
  • Feel socially anxious about your urinary incontinence
  • No longer participate in activities that bring you joy
  • Miss out on big moments or lose productivity

When to seek immediate help

In some situations, UI may be a sign of something more serious. If you experience any of these symptoms, please seek medical attention as soon as possible.

  • Appearance of blood in urine
  • Inability to urinate

How is urinary incontinence diagnosed?

Our goal is to help you feel better and feel as comfortable as possible along the way. In addition to talking with you and performing a pelvic exam (a quick check of your pelvic organs such as the vagina, uterus and rectum), there are a number of methods your doctor may recommend to diagnose your condition and determine the potential causes behind incontinence.

Keeping a bathroom journal

You may be asked to keep a bladder journal before or after your appointment. In your journal, you’ll log all your bathroom trips and bladder leaks or issues. This record will help your doctor get a more accurate idea of your symptoms and how often they occur.

Urine testing

For a urine test, you’ll provide a small sample. The lab will then analyze for different factors such as acidity, appearance, concentration and presence of infection.

Bladder ultrasound

During a bladder ultrasound, the nurse will move a handheld device across your abdomen to measure the amount of urine left inside your bladder after urinating.

Urodynamic testing

Your doctor may recommend additional assessments that measure bladder function.

Cystoscopy

This procedure allows your doctor to examine your urethra and bladder with the use of a small camera.

Non-surgical treatment options for UI

Fortunately, urinary incontinence has many treatment options. We recommend discussing your options with a doctor before deciding on the best course of action.

In some cases, your doctor might recommend lifestyle changes to help manage and prevent the symptoms of urinary incontinence. These range from adjustments to your diet, to exercise habits to management techniques between bathroom breaks. Here are some of examples:

Perform Kegel exercises

Kegels are a great way to strengthen the muscles in your pelvic floor – and get bonus points for being doable anywhere. If you’ve never done Kegels before, they’re simply the contracting and releasing of the muscles you use to stop and start the flow of urine. By practicing this quick exercise every day, you’ll strengthen those muscles important for bladder control. Just make sure to only do them when you don’t need to go. Try to complete about 10 sets of 10 contractions per day to maintain a strong and reliable pelvic floor.

Reduce your fluid intake

Drinking water is good for your body, and it’s important to stay hydrated, but overdoing fluid intake can lead to bladder urgency and leaks. The key to healthy fluid intake is maintaining a good balance. Try to drink water when thirsty, but not more of it than your body asks for. And keep an eye on the color of your urine. If it’s clear, you could probably cut back on fluid intake, but dark urine is a sign that you need more fluids.

Exercise more

Even though physical strain can trigger bladder leaks, it’s still important to remain active. By maintaining a healthy weight and exercising regularly, you may reduce your chances of experiencing UI and other health-related issues. Worried about leaks? If concerns about incontinence are preventing you from participating in physical activities at the gym or in a public place, try finding a more private space, like your living room, where you can feel comfortable exercising – at least until you feel confident enough to get out there again.

Change your diet

Caffeine, alcohol and other bladder irritants can be major triggers for UI. If you want to improve your symptoms, try to save the lattes and wine for special occasions and use extra precaution indulging in them.

Also be careful with food and drinks that are spicy or acidic. They can irritate your bladder, prompting contractions, which can lead to leaks. As a general rule, take note of any foods and drinks that make your symptoms worse, and try to keep a healthy, balanced diet rich in vitamins and nutrients.

Try training your bladder

Having a regular bathroom schedule can help teach your bladder to recognize when it’s time to go, reducing the number of leaks. It can also help slowly “train” your bladder to increase the amount of time between trips.

Use precaution

Precautionary products can protect yourself in high-risk situations, such as during physical activity or when you have limited bathroom access. The most common precautionary products are disposable pads, liners and underwear designed to act as an absorbent barrier between you and your clothes.

Use a urethral support device (pessary)

Your doctor may recommend fitting you with a device worn in the vagina to help prevent leakage with activity. An over-the-counter device called Impressa is also available.

Medicinal treatments for UI

Medications for urinary incontinence are specifically designed to treat urge incontinence. These medicines help prevent leaks by reducing the spasms in your bladder muscles that cause them.

Surgical treatments for UI

Surgery to treat stress incontinence is available and works by giving more support to the urethra. There are also procedures available to treat urge incontinence.

Our doctors will help to decide if a procedure or surgery is the best option for you and will walk you through how it works as well as answer any questions you may have.

We’re here to help

Still feeling unsure about your first step? Remember, incontinence doesn’t have to stop you from enjoying daily life on your terms. Getting the right diagnosis and treatment can be a life changer. Our team of compassionate urogynecology specialists will use their expertise to answer any questions you may have.

Learn more about OB_GYN video visits.