Are you always running to the bathroom, or do you leak urine when you run, cough or sneeze? Bladder leaks affect 1 in 3 women over the age of 18. In the United States alone, approximately 18-20 million women have some form of bladder leaking at some time in their life.
There are two main types of bladder leaks that women experience, stress and urge incontinence, and they’re usually due to weakened pelvic floor muscles. So, let’s discuss how your pelvic floor can weaken and what you can do about those embarrassing and frustrating leaks.
Your Amazing Pelvic Floor
Your pelvic floor supports your reproductive organs, bladder, and bowels so they can function properly, and the pelvic floor muscles give you control over your bladder and bowel functions. The nerves attached to the muscles in your bladder tell you when you have “to go”, but the muscles keep everything in until you get to the bathroom. The stronger your muscles, the more control you have and the longer you can wait.
As we age, the pelvic muscles can weaken, making them have to work harder and causing function and control to weaken as well. Supported by those muscles is your urethra. Your urethra is the tube that connects to your bladder and passes urine. However, because the urethra in women is so much shorter than men’s when those pelvic muscles weaken, women are more prone to leaks.
Common Type of Bladder Leaks for Women
Stress Incontinence is when there’s pressure on your bladder from any exertion like running or jumping, but also from simply sneezing, coughing, or laughing. It’s the most common type of bladder leaking for women between the ages of 18 and 44.
There are several things that can contribute to a weakened pelvic floor, increasing your risk of stress incontinence:
- Vaginal childbirth puts a lot of pressure on the pelvic floor, stretching those muscles – those who’ve had multiple births have a greater risk of stress incontinence
- During menopause or perimenopause, your ovaries begin producing less estrogen which protects your pelvic floor (besides weakening the vaginal tissues, loss of estrogen also affects your pelvic floor, contributing to weaker pelvic floor muscles)
- Chronic Coughing due to illness or smoking
- Pelvic surgeries including hysterectomy
- Being overweight or Obese can add pressure to your bladder
- Age – as we get older, our bladder muscles stretch, decreasing it’s capacity for holding urine.
Urge Incontinence is more common in older women. It is characterized as when you have a sudden urge to go, but because your bladder muscles can’t hold in the urine, you experience leakage.
The most common cause of urge incontinence is Over-Active Bladder (OAB) where you constantly feel like you have to urinate. The muscles in your bladder contract even when you don’t have a full bladder sending the signal to your brain that you have to go. OAB is a medical condition where urinary incontinence (UI) is a common symptom, but OAB doesn’t mean you’ll have urge incontinence.
Other risk factors for urge incontinence include:
- Being overweight
- Chronic constipation
- Pelvic floor surgery
- Nerve damage to the bladder
- Certain medications like diuretics
- Urinary Tract Infections (UTI’s)
Overflow Incontinence is where you can’t entirely empty your bladder, causing leaking. Although more common in men with prostate problems, it can happen to women as well.
Common causes of overflow incontinence include:
- Nerve damage from diseases like diabetes, Parkinson’s, or MS
- Certain medications like antidepressants and anticonvulsants
- Injury to the bladder nerves
- Weakened bladder muscles
Mixed Incontinence is when you have both stress and urge incontinence. Mixed incontinence is more common in older women.
Besides Giving Up Socializing, What Can I Do About Bladder Leaks?
Bladder leaks can be embarrassing enough to make you stop going out socially, exercising, or putting yourself in a situation where you may have an accident.
There are many solutions to help control bladder leaks, starting with lifestyle changes like decreasing fluids, not smoking, and eating more fiber. Your doctor can also recommend a treatment plan that may include bladder training, vaginal inserts to strengthen your pelvic floor, medications, or even surgery.
Below are the common treatment methods for bladder leaks:
- Bladder Training – Going at regular intervals, and then getting consistently longer, can train your bladder to hold urine, so you can wait to get to the bathroom.
- Pelvic Floor Exercises like Kegel, done properly, can strengthen your pelvic muscles
- Estrogen therapy, both oral and topical can help strengthen your pelvic floor giving you better control
- Lose weight if you’re overweight
- Eat a balanced diet including fiber-rich foods
- Stop Smoking
- Constipation can add pressure to your bladder
- Avoid spicy foods and stimulants like caffeine
- Limit Alcohol
- Medications are available for urge incontinence
- Surgery may be an option by repairing your pelvic floor or attaching a sling to support the organs.
Bladder leaks are not something you have to live with. If you’re tired of wearing pads or having embarrassing accidents, talk with your doctor. They can help you develop a plan to control or relieve your bladder issues.
Don’t wait. It’s time to get on with your life and enjoy living again.