We don’t like to talk about it (except maybe with our closest friends) but if you’re over 60, you’ve likely experienced a leaky bladder or some form of urinary incontinence (UI) — the lack of voluntary control of your bladder function. We know how inconvenient and even embarrassing bladder problems can be, but the truth is, lots of women — of all ages — silently live with them. In fact, it’s estimated that 25 to 45 percent of women experience some form of urinary incontinence.
Like most people, you may think incontinence is “just part of getting older” but the truth is that it’s actually not a normal part of aging. Incontinence is not a disease or condition but rather a symptom of an underlying issue — and it can be corrected.
One in four women older than 18 has episodes in which she involuntarily leaks urine. Among women with urinary incontinence, less than 50 percent have discussed it with their physician.
For women, most bladder leakage problems are the result of a specific type of urinary incontinence known as stress incontinence — the most common form of incontinence in women of all ages. However, there are other types of urinary incontinence some women may experience.
Stress incontinence is leaking that occurs from putting physical stress on your bladder. Coughing, sneezing, laughing and even exercise are the usual culprits. Even lifting something heavy can put stress on your bladder.
This condition is caused by the weakening of the pelvic floor muscles — the muscles that support your bladder and other pelvic organs. This weakening can happen after childbirth or after menopause because of the lack of estrogen production. Stress incontinence is twice as common in women than in men.
Often referred to as “overactive bladder,” this type of incontinence is sudden and urgent. The bladder contracts abnormally and urination comes with very little warning. Bladder function may be irregular due to nerve damage from diabetes, a stroke, or conditions like Parkinson’s and multiple sclerosis.
Urge incontinence commonly affects older adults, women who have had some type of pelvic surgery, and those considered to be overweight or obese.
What causes bladder problems?
Remember when we said that urinary incontinence is not a normal part of aging and that it’s typically a symptom of another issue? All of the incontinence issues mentioned above are primarily caused by:
- Pregnancy and childbirth: During pregnancy, babies push down on the bladder and other muscles, causing them to stretch and weaken. Child labor can weaken these muscles and even damage nerves that control the bladder.
- Excess weight: Being overweight can put additional pressure on the bladder, which can lead to incontinence.
- Menopause: The loss of the production of estrogen after menopause can weaken urethral tissue.
- Caffeine or alcohol: Drinking a lot of caffeine or alcohol can sometimes irritate the bladder and increase the production of urine.
- Diet: Spicy or acidic foods can irritate the bladder.
What can we do?
Maybe you recognized some of your own symptoms in the list above or maybe you’re worried that you could eventually develop a form of urinary incontinence. Before worry sets in, it’s important to remember that UI problems affect lots of women, and the good news is that most of them are treatable and can be managed.
Treatments typically range from strengthening your pelvic floor with kegel exercises to monitoring your fluid intake, medication or in some cases a minor surgery if other treatments aren’t effective.
“Doctors have more tools than ever to treat incontinence,” said Michael Carley, MD, a urogynecologist on the medical staff at Baylor University Medical Center in Dallas. “A strategy called time voiding encourages women to go to the bathroom on a set schedule, rather than waiting for the urge to strike. Medications that act as muscle relaxers can prevent, or at least delay, the bladder from contracting. Botox injections can accomplish the same result.”
If you’re concerned about your bladder health, you should talk to your OB/GYN about any symptoms you’re experiencing. You may be referred to a specialist — a urogynecologist — for treatment if needed.