Female Urinary Incontinence – Causes and Management Options
Many women live with urinary incontinence, but not all are brave enough to seek proper treatment. In fact, some change how they live daily life because of incontinence – they go out less, side step getting together with friends. Some even give up activities they enjoy, like their yoga class, because of fear of having an accident in public.
This can lead to isolation and even depression for the women who feel like they can no longer freely do what they want, what they love. Of course, disposable diapers are readily available, but this, too, can be an emotional downer to face – wearing them can make you “feel old.”
Read on to learn more about urinary incontinence in women and find the right information to manage it.
What Is Urinary Incontinence?
Urinary Incontinence (UI) refers to the involuntary leakage of urine. It varies in severity and ranges from a few drops of urine, such as dribbling after urination, to complete bladder emptying before you can reach a restroom. This incontinence is twice as common in women as men and affects females of all ages. Studies show that nearly 25% of young women, 44-57% of middle-aged women, and 75% of mature women experience some type of unintentional loss of urine.
Research found that more than 25 million adults in America and close to 200 million adults globally are affected by urinary incontinence. In the U.S. alone, approximately 15 million women suffer from urinary incontinence. However, nearly 50-70% of women with urinary incontinence don’t seek medical evaluation and treatment due to embarrassment or social stigma.
Causes of Female Urinary Incontinence
Urinary incontinence (UI) in women is caused by an issue with the nerves and muscles that work together to hold and release urine in the bladder.
Though it is often dismissed as an inevitable part of the aging process, female urinary incontinence is a symptom of a condition, most often weakened pelvic floor muscles. Other triggers of UI are urinary tract infections. Specific changes in bodily functions because of disease, medication, or the onset of an illness can also cause urinary incontinence.
In addition, women often develop incontinence during pregnancy, childbirth, or after the hormonal changes experienced during menopause. Being overweight, constipation, nerve damage, surgery, and too much caffeine are factors that are known to cause urinary incontinence.
If you experience symptoms of urinary incontinence, don’t be afraid to consult your primary care physician. Your doctor may refer you to a specialist, who will likely be a urologist (a doctor who specializes in diseases of the male and female urinary tract) or a urogynecologist (a doctor trained in urology and gynaecology who diagnoses and treats women with pelvic floor problems).
Types of Female Urinary Incontinence
Here are three of the most common types of female urinary incontinence:
1. Stress incontinence
Stress urinary incontinence results from physical exertion or effort or any other kind of bodily movement that puts pressure on the bladder, like sneezing or coughing. It is the most common cause of urinary incontinence in younger women.
Common in: Younger women after the experience of childbirth. 24-45% of women older than 30 years.
Causes: Pregnancy, vaginal births, obesity, chronic constipation, radiation or surgery to the vaginal area, chronic lung disease.
2. Urge incontinence
Also called overactive bladder, urge incontinence refers to the sudden, strong urge to urinate followed by involuntary leakage of urine before one can get to a toilet in time. Some women feel the urge to pass urine many times during the day but don’t urinate much once they get to the restroom.
Common in: 9% of women aged 40-44 years. 31% of women over 75 years.
Causes: Anxiety, bladder irritation and complications, vaginal atrophy, disorders that affect the nervous system, e.g., spinal cord injury, dementia, stroke, or Parkinson’s disease.
3. Mixed incontinence
Some women involuntarily pass urine with physical activity (stress incontinence) and frequently feel the urge to urinate (urge incontinence). This is called mixed incontinence, where you experience symptoms of two or more types of UI.
Common in: 20-30% of female patients with chronic incontinence.
Causes: A combination of the same factors that cause stress and urge urinary incontinence.
Management and Treatment for Female Urinary Incontinence
It is crucial for women with a leaky bladder to consult a healthcare provider who can diagnose the cause of urinary incontinence. This information will help determine the most effective treatment options. Your doctor will likely ask about your symptoms and medical history and carry out a physical exam and other tests.
Several products and devices are available to help women manage urinary incontinence as they wait for a diagnosis or for treatment to take effect.
1. Disposable pads, liners, and adult diapers
Regular sanitary pads are not made to absorb urine. They may work for occasional urinary spotting and drips, but will not manage more frequent drips, dribbles or leaks well.
Incontinence pads, liners, and adult diapers are made for urine leakage and soak up more fluid than sanitary pads. Depending on how much urine you leak, you will need liners, pads, or adult diapers.
2. Reusable incontinence underwear
Washable incontinence underwear is a great eco-friendly alternative to disposable products. The key to a good fitting pair of incontinence underwear is that they should be comfortable and undetectable under your clothes, just like your regular panties. A good quality pair of incontinence panties, like those available at zorbies.com, should have enough stretch to fit snugly against your skin while giving you easy freedom of movement to exercise or engage in outdoor activities.
3. Intravaginal bladder support
An intravaginal bladder support device is inserted into the vagina using a tampon-style applicator. Unlike the absorbent fiber composition of a tampon, the bladder support is made of collapsible silicone structures. They expand to lift and support the urethra from inside the vagina, thus helping to stop leaks caused by physical activity or body movement.
The treatment you receive will depend on the type of urinary incontinence you’ve been diagnosed with and the severity of your symptoms. Treatment options may include:
- Behavioral therapies like bladder training and toileting assistance.
- Diet modifications like reducing the intake of foods known to be bladder irritants, such as alcohol, citrus fruits, and caffeine.
- Pelvic muscle rehabilitation to prevent bladder leakage and improve muscle tone. This includes Kegel exercises, biofeedback, vaginal weight training, and pelvic floor electrical stimulation.
- Medication like vaginal estrogen
- Using a removable device like a pessary
- Minimally invasive in-office procedures like injecting botox into the bladder and peripheral nerve stimulation