Leaking urine, be it a few drops or a stream, is not a normal part of the aging process. Women should not accept this as normal life progression. Leaking urine, or urinary incontinence (UI), is treatable. People of all ages experience UI. It is a reason to see a healthcare provider.
Women of all ages experience UI.
Urinary incontinence should be evaluated at annual exams to implement prevention measures when necessary.
A weak pelvic floor, urethral neck, or sphincter are reasons for urinary leakage.
Pressure on the bladder with a weak pelvic floor result in UI.
Urinary incontinence can be treated with changes in lifestyle and exercise.
See your healthcare provider if you have urine leakage.
Urinary incontinence overview
Urinary incontinence affects close to 18 million women. There are three types of incontinence:
- Stress urinary incontinence (SUI)
- Urge incontinence
- Mixed incontinence
Stress urinary incontinence is the unintentional loss of urine. This occurs when pressure on the bladder causes leakage. There is no sudden urge to urinate.
Urge incontinence is the sudden, unstoppable loss of urine. It is an extreme urge to urinate and insufficient time to make it to the toilet.
Mixed incontinence is having a combination of both SUI and urge incontinence. There is leakage, as well as the sudden urge to urinate.
It is accepted that UI is a part of having children and getting older. However, the fact is that UI, specifically SUI, occurs in younger women.
A study showed that women 22 to 27 years old experience UI. It aimed to identify the characteristics of young women who experienced UI. They learned that, of those reporting UI, on average, they were seven kilograms (15 pounds) heavier than those who did not. The study concluded that an obese BMI, high psychological distress, and having at least one child were commonalities in the group who had experienced UI.
Urinary incontinence is a problem that can affect teens and young women but is rarely talked about. Sports injuries are the most frequent cause of UI in this age group. A cross-sectional survey showed that women 18 to 40 years old who participated in high-impact sports, or a high volume of daily exercise, had higher incidences of UI.
Why urinary incontinence happens
There are three causes of UI:
- Muscle overactivity
- Muscles fail to stretch
- Bladder hypersensitivity
While these are very broad explanations, there are more specific reasons why someone may have UI. Age is not the only reason. Women of all ages experience UI.
A common cause of UI among young people is high-impact sports. Athletes participating in these sports experience UI. Still, because of the stigma of this condition, most find a way to manage it, like adjusting clothing or performance to minimize the leakage.
High-impact sports can cause the weakening of the pelvic floor muscles. Jumping and landing hard and tightening core muscles create pressure on the bladder and can cause leakage.
Too much exercise
Exercise is a good thing. It is beneficial to the body in so many ways. Yet, sometimes exercise is too strenuous for the body.
Increased frequency of exercise may weaken the pelvic floor as well. Having this weakened pelvic floor, those who exercise frequently may also experience UI. Even if it is just a little leak, it is UI.
High body mass index
One correlation with UI is a body mass index (BMI) of 30 or above. Studies have shown an increased incidence of UI as BMI increases.
Though there is a strong correlation between high BMI and the incidence of UI, the reason for the correlation remains unclear. More research is needed to understand the effects of high BMI on UI completely.
Sexual intercourse may cause UI. There can be leakage during sex. Here, again, the weak pelvic floor is to blame.
While having sex, the pressure may become too much on the bladder, and the weakened pelvic floor allows urine to leak outside the body. It happens in cases when there is enough movement during sex to cause such pressure on the bladder.
All these reasons are the result of SUI. They all put pressure on the bladder, and because of the weakened pelvic floor, there is leakage.
Impact on quality of life
Urinary incontinence can harm a person's quality of life. It can be embarrassing, stressful, and overwhelming. Living with urinary incontinence can lead to depression and other health issues, such as skin breakdown.
A nurse identified as “J.” experienced SUI for eight years. She was a social person. Her social outings came to a screeching halt when she began to smell like pee.
Smelling like pee is not often mentioned when speaking about UI and its impact on the quality of life. A person may become a social outcast.
J. started to experience that exact scenario. She was too embarrassed to be with other people. She was afraid she was stinky.
Her activities became limited. When on walks with her family, she would leak a stream of urine. She couldn’t jump on the trampoline with her daughter for fear she would pee on herself.
Ways to treat urinary incontinence
There are three types of treatment: behavioral, pharmacological, and surgical. Before receiving treatment, a healthcare provider will have completed a thorough exam to determine the best treatment for you.
It is suggested that all patients try a behavior treatment option before seeking other therapies. These options are often things that can be easily done at home. A few of these are:
- Pelvic muscle exercises
- Bladder retraining (timed voiding)
- Diet changes
- Increase exercise for those with high BMI but low activity
- Decrease exercise amount and intensity
Some medications are used to treat urinary incontinence. Pharmacological therapies may include:
- Oxybutynin – an anti-cholinergic that inhibits contractions in the bladder.
- Tricyclic anti-depressants – these aid in urethral contraction and closure.
- Estrogen – this increases urethral blood flow.
Surgical therapies are considered for those who are bothered by persistent symptoms and when behavioral and pharmacological treatments have failed.
There are three types of surgical procedures used to treat urinary incontinence:
- Urethral bulking agents
Except for the urethral bulking agents, all surgeries involve some way of supporting the bladder in place of the weak pelvic floor.
After discussing options with her healthcare provider, J. decided to have surgery. She reported no complications during or after surgery and hasn’t had SUI since. And, it must have done the trick because J. has since married and resumed her social lifestyle.
How to prevent urinary incontinence
Urinary incontinence should be assessed at annual examinations. In doing so, patients can be educated about the ways to avoid having UI, such as:
Avoid bladder irritants such as caffeine, alcohol, citrus fruits, chocolate, tomato, spicy foods, and tobacco.
Know the signs and symptoms of pelvic floor dysfunction.
Know the increased risk of participating in high-impact sports or high-volume exercise.
Women of all ages experience UI. It is not something that is part of aging and it is treatable. If you suspect you are at risk of having UI, there are ways to help prevent it.
Treatment for UI is available. These options range from lifestyle changes to surgery. Women should see their healthcare provider explore their treatment options.