Many women, at one stage of life or another, experience that annoying leakage of urine when their bladder is too full, and/or when laughing, running, jumping, or sneezing. For some it occurs after childbirth when all of those muscles down in the pelvic region are stretched out and recovering. For others, it occurs later in life with the change of hormones and loss of estrogen.
There are three most common types of incontinence. Stress incontinence occurs when you put stress or pressure on your bladder with coughing, sneezing, or running. Urge incontinence happens when you have the immediate "urge" to urinate and can’t seem to hold it. Mixed is a combination of both. Urine is specifically kept in the bladder until you are ready to use the bathroom, however if the detrusor muscle and urethra aren’t behaving like they should, you leak.
Research suggests that 30 to 40 percent of women 60 years and older deal with incontinence. Risk factors include: pregnancy, multiple births, menopause, obesity, diabetes, certain autoimmune conditions, prolapse, abdominal surgery, diuretics, anxiety, nerve damage to the mid-low back, bladder infections, overactive bladder, inability to urinate regularly when needed, and stimulants such as coffee/soda/chocolate.
Evaluation by your health care provider, or a specialist called a urogynecologist, often involves a full intake surrounding the situations in which you are incontinent, your history, medications, and pregnancy history. A vaginal physical exam is important to assess for proper anatomy and then testing may be needed such as a hormone testing, urinalysis (to look for infection), a bladder stress test, an ultrasound of your kidneys/bladder/ureters, or cystoscopy (a scope inside your bladder).
Treatment depends on what they find. It may be something like pelvic floor physical therapy where you learn how to do a proper Kegel exercise and recruit all of your muscles, not just the strong ones. It may require bladder retraining, hormone evaluation, weight loss coaching, or surgery in some cases.
If you are leaking more than you would like, please talk with your health care provider about your options.
1.Gomelsky A, Dmochowski R. Urinary Incontinence in the Aging FemaleAging health. 2011;7(1):79-88.
2. Password F., View I. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 2001; 87: 760–6.http://www.ncbi.nlm.nih.gov/pubmed/11412210
Reviewed June 3, 2011
Edited by Alison Stanton