Bladder control issues can be difficult to discuss with your doctor. But female incontinence is a common condition with many successful treatments.
by The Iowa Clinic on Thursday, April 4, 2019
A little leakage after a cough, sneeze or laugh is an all-too-familiar feeling for pregnant women and new moms. In the comfort of your own home or with knowing fellow moms, it can be equal parts funny and embarrassing. In other situations, it’s almost always the latter.
But what happens when your leakage lingers? Or if it isn’t from bearing a child at all?
You have urinary incontinence.
When you lose control of your bladder, that’s called incontinence. It’s twice as common in women than men. You can thank pregnancy, childbirth and the female anatomy for that. There’s much more to incontinence than a few drips after a good laugh. You can have sudden, uncontrollable urges to run to the restroom — and not enough time to make it there — or a variety of other related issues.
6 Types of Incontinence in Women
Incontinence comes in many forms, each with its own set of causes. Identifying the type of bladder issue that’s affecting you — and what’s leading to it — puts you on the path back to worry-free living.
- Stress incontinence – When additional stress is placed on your pelvic floor muscles, or the muscles are just weak, your bladder can’t control the added pressure. So you leak. Coughing, sneezing, laughing, exercising, obesity, lifting heavy objects or carrying a baby in your tummy are all things that put stress on your pelvic floor muscles and bladder.
- Urge incontinence – Put simply, you have an overactive bladder. You either urinate often and through the night or can’t control sudden, strong urges — leading to embarrassing accidents. Bladder infections, bladder stones, muscle and nerve damage and side effects of medications are the most common reasons for it.
- Overflow incontinence – Your bladder never completely empties, causing a constant dribble after you’ve already gone to the bathroom. It has many of the same root causes as stress and urge incontinence.
- Functional incontinence – This one’s caused by a physical or mental issue that makes you too slow to get to the restroom before the flow of urine starts.
- Mixed incontinence – Just as it sounds, mixed incontinence means you have multiple things contributing to your bladder issues. Many women experience both stress and urge incontinence.
- Bowel incontinence – The same issues that affect your urine control can affect your bowels. Forty percent of women who have urinary incontinence also have bowel, or fecal, incontinence.
You shouldn’t have to worry about wetting yourself.
Many women, especially new moms, live with the occasional dribble or two long after giving birth or first showing incontinence symptoms. But it doesn’t have to be that way! Incontinence isn’t inevitable — it’s fixable. And there are many different ways to treat your issues, from simple lifestyle changes to medications.
Treatments for Female Incontinence Issues
Since urinary incontinence has a handful of types with numerous potential causes, a number of healthcare providers treat the condition. Urologists, gynecologists and urogynecologists — OB/GYNs with extensive training in female incontinence and pelvic organ prolapse — can treat you. Also, physical therapists who specialize in pelvic health can help you strengthen your pelvic floor muscles to eliminate incontinence. Depending on your specific issue, your treatment may include:
- Bladder training – If you’ve raised children, you know you’re not born with bladder control — you learn it over time. When you’re having trouble with uncontrollable urges, you can retrain your bladder or simply monitor and time your potty breaks to keep from leaking.
- Pelvic floor exercises – Similar to how you need to retrain your bladder, you need to retrain your pelvic floor muscles to strongly contract to stop the flow of urine. You’ve probably heard of Kegels. It’s a common pelvic floor strengthening exercise recommended for women after pregnancy and childbirth.
- Biofeedback – This technology lets you see what’s going on when you contract your pelvic floor muscles. By seeing the strength and endurance of your muscles, physical therapists can prescribe the right exercises to help you regain control.
- Medications – Sometimes prescriptions are necessary to manage your urinary incontinence. Meds can help stop an overactive bladder by blocking the contractions.
- Injections – For severe cases of stress incontinence, collagen shots in your urethra can provide long-term relief of symptoms without surgery.
- Pessary – A small medical device inserted into the vagina, a pessary stops leakage by doing the work your muscles are unable to.
- Neuromodulation – This in-office procedure uses gentle electrical stimulation to encourage proper bladder and bowel control.
- Surgery – In the most extreme cases, surgery is necessary to completely resolve urinary incontinence. There are several different surgical options that relieve pressure on the bladder, prevent leakage or increase the amount of urine your bladder can hold.
You don’t have to feel embarrassed about your bladder issues.
Urinary incontinence can quickly change from slight embarrassment to major social problem. One or two incidents — or the mere threat of leaking — can make you avoid social situations, withdraw from your normal life or become depressed.
While urinary incontinence is much more common once you hit 65, 10 percent of women experience it before old age. If you have a mom’s group, you may even hear it happening more frequently amongst your friends. And if you’re not too embarrassed to confide in your friends, you shouldn’t feel ashamed bringing it up to a medical professional.
Your provider will have questions. But they’re just trying to diagnose the type of urinary incontinence you’re experiencing in order to find the best solution to relieve it. If the discomfort is too much, there’s another way you can help them.
Pour it all into your diary — a bladder diary. Watch your urinary habits closely. List out everything you eat and drink. Count and time your bathroom breaks. Gauge the strength of your urine flow. Take note of any accidents and what led to them.
Then hand it over to your primary care provider or gynecologist to start the conversation. If the problems persist or you can’t find the right treatment, ask for a referral to a specialist to end your incontinence.