Remember that time in grade school when you laughed so hard that you peed your pants? It was hilarious. Now do you remember that time you laughed so hard you peed your pants as an adult? Not as funny. No one likes to talk about it, but many women deal with bladder control problems. Urinary incontinence is the medical term for involuntary bladder leakage and it affects more than 60 percent of women at some point.
While urinary incontinence can happen at any age, it becomes more common around menopause. In fact, it’s estimated that between 30 to 40 percent of women are affected in the years leading up to menopause, a number that jumps to over 50 percent after menopause.
Having a leaky bladder can be frustrating, but there are a range of treatment options available. Here’s how to find relief.
Types of urinary incontinence
While there are several different types of incontinence, the most common is stress incontinence — involuntary leakage from physical activity, such as laughing, exercising, or lifting weight. These instances account for about 90 percent of all incontinence problems, according to Dr. Lisa Hawes, a urologist with Chesapeake Urology Associates. Psychological stressors, such as as anxiety, can also trigger incontinence.
A less common type is urge incontinence, also known as an overactive bladder, which occurs when the bladder contracts or spasms at unexpected times. Mixed incontinence is combination of these two types.
What causes a leaky bladder?
A number of factors can increase the risk of a leaky bladder. Age is one common cause. Aging decreases pelvic function, Flow Advisory Council member Uchenna (UC) Ossai, DPT, a pelvic health physical therapist at YouSeeLogic, explained in an earlier interview. Declining levels of estrogen during perimenopause and menopause also weaken the muscles of the pelvic floor, making accidents more likely.
Weight gain is another risk factor as it also can weaken the muscles of your pelvis. This is why stress incontinence is common during pregnancy, when the increased weight of an enlarging uterus puts pressure on the pelvic floor. Childbirth can also strain or damage bladder nerves and supportive tissues.
Medical issues such as diabetes or a urinary tract infection (UTI) can also cause incontinence. Diet can play a role as well: Drinking diuretics such as alcohol or caffeine can give you a sudden urge to pee as can foods or beverages high in artificial sweeteners, corn syrup, spices, and acid.
How to treat a leaky bladder
It’s important to seek help for incontinence — there are many treatment options available and no one should have to just live with it. “Urinary incontinence can result in recurrent urinary tract infections, skin irritation, social isolation, and depression,” says Dr. Phillip Hoekstra, a urologist at Spectrum Health.
If you’re experiencing incontinence, start by reaching out to your healthcare provider, who may refer you to a urologist or urogynecologist. Depending on their assessment, they may recommend medical or non-medical interventions.
A person dealing with stress or urge urinary incontinence often benefits from seeing a pelvic specialist. This type of provider can guide you on how to perform kegels, stretching, vaginal weight training, or other exercises, to strengthen pelvic muscles and hold urine in more effectively. There are also a range of helpful pelvic floor therapy resources online.
If pelvic floor therapy and lifestyle changes don’t help, surgery is another option. If surgery is necessary, Dr. Mary South, a urogynecologist at Northeast Ohio Urogynecology, says it is often minimally invasive. One common treatment is a mid-urethral sling, a short procedure where a mesh sling is placed to support the urethra and can be up to 90 percent successful in stopping bladder leakage. Other procedures involve a having a material similar to collagen injected around the urethra to build up thickness which can support a weak pelvic floor.
As you work to find relief, it can help to wear pads or protective underwear. There are a range of modern incontinence products available, in particular from companies that make period underwear, like Knix, Thinx, and Jockey. It can also be helpful have an idea of where the public restrooms are when you’re out and about. And if exercise is a trigger, plan to use the bathroom before working out even if you don’t feel an immediate urge.
A leaky bladder is common, but not normal
Though it’s common, doctors say urinary incontinence should never be considered normal.
“Often, urinary incontinence has been considered to be part of the aging process, but it need not be,” says Dr. Gary Lemack, a professor of urology and neurology at the University of Texas Southwestern Medical Center. Dr. South agrees: “Bladder leakage is never normal. Treatment is available, and a woman should seek consultation with her physician or ask for a referral to a urogynecologist.”
Almost all forms of incontinence are treatable, and identifying the type of bladder leakage is essential to getting the right care. In rare circumstances, a leaky bladder can be a sign of a more pressing health condition making it all the more important for you to seek care from a healthcare provider.