Urine leakage is more common in women than in men. It occurs across all ages, but more women tend to experience this issue after they go through menopause. For those affected, it is important to understand that many of the causes of urinary incontinence are temporary and the condition is usually treatable.
Who is Likely to Have Bladder Control Problems?
Although bladder control issues can be embarrassing, they are very common. About half of adult women say they have had urine leakage at one time or another, and many women say the problem occurs on a daily basis. While younger women typically experience leakage during pregnancy and after childbirth, postmenopausal women usually leak while exercising, laughing hard, coughing or sneezing. These activities put added pressure on the bladder and lead to stress incontinence accidents.
What Causes Bladder Control Problems in Women?
A number of different factors can contribute to urinary incontinence. Older women typically have more than one of these factors, making them more prone to leakage. The most common reasons for bladder control problems are listed below.
- Weak Muscles
Pelvic floor muscles—the muscles that hold the bladder and other pelvic organs in place become stretched and weak during pregnancy and childbirth. Advancing age also causes a natural loss of muscle tone and strength. Weakened pelvic muscles and sphincters cause a loss of control over the release of urine.
- Nerve Damage
Damaged nerves may send signals to the bladder at the wrong time, causing the bladder to release urine without warning. They may also send no signals at all, which prevents the brain from sensing when the bladder is full. Vaginal childbirth, stroke, and diseases like multiple sclerosis and diabetes can damage the nervous system and cause urinary incontinence.
Certain prescription medications can affect muscles and nerves that play a part in bladder control and lead to drug-induced urinary incontinence. Diuretics, ACE inhibitors, sedative-hypnotics (like Valium, Ativan and Xanax), calcium channel blockers, and some antipsychotics and antidepressants can all cause a loss of bladder control.
- Alcohol and Caffeine
Certain foods and drinks can exacerbate incontinence as well, especially those containing caffeine and alcohol. Both are diuretics, which means they increase the production of urine. For someone who already experiences bladder control issues, additional urine can lead to accidents. Caffeine and alcohol may also irritate the bladder.
One of the tell-tale symptoms of a urinary tract infection (UTI) is strong and frequent urges to urinate. The infection causes irritation to the bladder which may lead to the involuntary loss of urine.
- Excess weight
Being overweight can put extra pressure on the bladder and contribute to leakage.
Treatments for Urinary Incontinence
For women who are experiencing bladder control issues, a few simple lifestyle changes can help to minimize leakage. If episodes of incontinence tend to occur at certain times of the day, be mindful of the time and plan trips to the bathroom to avoid accidents. If certain foods and drinks cause a noticable increase in the frequency of urination, try avoiding them. A food diary can help pinpoint which ingredients are the culprits. Achieving a healthy weight, not smoking and regularly performing kegel exercises to strengthen pelvic floor muscles can all help to minimize symptoms of urinary incontinence.
Don’t be embarrassed to talk with a doctor about incontinence. They will perform urinary incontinence testing to help determine the underlying cause(s) of the leakage and recommend a personalized treatment plan. Treatment could include any of the lifestyle changes above, prescription medication to calm an overactive bladder, or a device worn in the vagina that helps lift and support the bladder. In severe cases that do not respond to these treatments, surgery may be necessary to improve bladder control.
Source: National Institute on Aging (NIA), https://www.nia.nih.gov/health/urinary-incontinence-older-adults