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 nonsurgical 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 nonsurgical, medicinal and surgical treatments for UI.
What is urinary incontinence?
Urinary incontinence is involuntary loss of bladder control, which is different than frequent urination. It can happen when your bladder muscles are too weak or too active, and UI can be a temporary concern or a chronic issue.
It’s a myth that UI is just part of aging. It’s a medical condition that may affect women of any age, and there are many different ways to manage your symptoms so you can say goodbye to surprise leaks.
Types of urinary incontinence
There are four different types of urinary incontinence: stress incontinence, urge incontinence, mixed incontinence and overflow incontinence. Each form of UI comes with its own distinct symptoms. Let’s talk about 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 it can 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 leak out. This can be either from the inability to fully empty your bladder during urination, or just not realizing you need to go. With this kind of UI, your bladder leak may be continuous.
Symptoms of urinary incontinence in women
The symptoms of UI in women can vary from person to person. If you’re not sure whether you’re dealing with urinary incontinence, pay attention to the following symptoms:
- Leaking urine when you sneeze, laugh or cough
- Feeling like your bladder is never completely empty
- Constantly feeling like you need to pee
- Often waking up in the middle of the night to pee
- Feeling like you have to pee right after you pee
- Avoiding certain activities because you’re afraid of leaking
- Rushing to the restroom because you’ll leak if you don’t make it in time
- Suddenly noticing that you need to pee all the time
Causes of urinary incontinence in women
There are several causes of urinary incontinence in women, including weakened pelvic muscles, pelvic organ prolapse and UTIs. Factors including your age, weight, medications you take, and whether you’ve ever been pregnant can also affect your bladder control.
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 while 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.
Factors that can increase the risk of developing urinary incontinence in women include:
- Pregnancy and delivery
- Weakened pelvic floor muscles
- Pelvic organ prolapse
- Alcohol and caffeine consumption
- Excessive fluid intake
- Some medications
- 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 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 bathroom journal before or after your appointment. In your journal, you’ll log all your bathroom trips and bladder leakage or issues. It can also be helpful to record what you eat and drink in your bladder journal. This record will help your doctor get a more accurate idea of your symptoms and how often they occur. Keeping a journal can also determine what triggers your need to pee or any accidents.
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.
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.
Your doctor may recommend additional assessments that measure bladder function. Urodynamic testing measures how well your bladder, urethra and sphincter muscles work together to store and release urine.
This procedure allows your doctor to examine your urethra and bladder with the use of a small camera.
Nonsurgical treatment options for UI
Fortunately, there are several nonsurgical treatments for urinary incontinence. From training your bladder and pelvic floor exercises to using a urethral support device, there are different options you can try to manage your symptoms. 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. Common nonsurgical treatments for urinary incontinence are:
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.
Even though physical strain can trigger bladder leakage, 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.
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.
Try pelvic floor therapy
Pelvic floor therapy is a type of specialized physical therapy that strengthens the muscles that support your bladder and bowels. This can be very effective in treating urinary incontinence caused by an overactive bladder.
During pelvic floor therapy, a physical therapist may lead you through exercises that target your pelvic floor, use mild electrical stimulation to help you have more awareness of your pelvic floor muscles, and use other specialized techniques. If you’re interested in pelvic floor therapy, talk with a doctor about getting a referral.
Use a urethral support device (pessary)
Your doctor may recommend fitting you with a device worn in the vagina to help prevent bladder leakage with activity. An over-the-counter device called Impressa is also available.
Medical 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
Bladder control surgery to treat stress incontinence is available and works by giving more support to the urethra. The support keeps you from leaking when pressure is put on your bladder or your urethra, putting you in control of when it’s time to go. 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.
How to get help for female urinary incontinence
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.
If you think that you might have urinary incontinence, reach out to one of our primary care doctors. We’ll answer any questions you may have and guide you to treatment that will work for you. If specialty care is needed, we’ll refer you to our team of compassionate urogynecology specialists.