What Causes Incontinence In Women?

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Incontinence is a condition that affects over 25 million men and women in America. It can really happen to anyone, and can be caused by many different things. But it is much more common in women – nearly twice as common actually – and unfortunately has become something that many people (even potentially your doctor) brush off as being a normal part of aging. This couldn’t be further from the truth.

Why Is Incontinence More Prevalent In Women?

Incontinence can have many root causes.  Being overweight, problems with the prostate in men, and even conditions that cause damage to the nerves, such as multiple sclerosis, Parkinson’s disease, or even diabetes can all lead to incontinence.  But it’s no secret that women suffer from incontinence more than men. This is in part due to the fact that things like pregnancy, childbirth, and menopause are unique to women and create extra pressure and complications that can cause incontinence. 

The pressure of carrying a baby for 9 months and the trauma of childbirth to the pelvic floor can weaken the pelvic floor, making it difficult to stay continent.  Additionally the hormonal changes that occur during menopause cause a change in continence.  A decrease in estrogen can cause the vaginal tissues to become less elastic and dry and can lead to incontinence and urinary tract infections.

What Types Of Incontinence Are There 

Did you know that there are actually different types of Incontinence? Depending on what you have, there may be different options available to you.

Urge Incontinence

Urge incontinence is the frequent and urgent need to use the bathroom, accompanied by bladder leakage.  You may have a sudden feeling that you have to go to the bathroom right now, or it may be triggered by familiar things, such as arriving home, washing the dishes, etc. This type of condition may also exist without bladder leakage, and is then referred to as Overactive Bladder. 

Stress Urinary Incontinence

Stress urinary incontinence happens when pressure is placed on the bladder and causes bladder leakage. This type of leakage might happen when you’re working out, or even when you sneeze or laugh. Unlike Urge incontinence, stress urinary incontinence is not typically accompanied by the sensation of a sudden urge to urinate. Rather, stress urinary incontinence is caused by a weakened pelvic floor, and/or a weak sphincter muscle.  Stress urinary incontinence often occurs in women (although men can have it too), and typically as a result of pregnancy and childbirth. It’s a condition that can get worse as you get older, since we lose pelvic muscle tone as we age. Luckily, there are many treatment options available, and behavioral modifications, such as learning how to create a healthy pelvic floor, can do wonders for this type of incontinence.

Mixed Incontinence

As the name implies, many women can suffer from both Stress Urinary Incontinence, and Urge Incontinence, although one is typically more severe than others. Treatment options for mixed incontinence are typically the same as the treatments you would use for stress urinary incontinence, or urge incontinence.

What Are My Options?

Luckily, there are many treatment options available for the various types of incontinence women tend to have.  Below are just a few treatment options available.

Behavioral Modifications.

Often, simple changes to our lifestyle, including changes to our diet and exercise regimen, can ease a lot of the symptoms of incontinence in women.  Learning the foods and drinks that irritate the bladder, and knowing how to strengthen the core and pelvic floor muscles can do a great deal to help reduce or even eliminate symptoms.

 Absorbents

Absorbent products come in all shapes and sizes and are a great option for those who need some extra protection. Read our guide to finding the right absorbent product for you.

 Medications

There are many types of medications available that can sooth an irritable bladder. These medications typically work by relaxing the muscles around the bladder, or stopping the signal to your bladder that you need to go right now!

Procedures

If medications and behavioral modification don’t work for you, there are several options that you may want to try before you think about surgery. Many women have seen success with botox injections into their bladder (it’s not just for wrinkles!), and different forms of neuromodulation, small pulses that stimulate the nerves involved in controlling the bladder.  Learn more about these options here.

Surgery

Finally surgery can be a good option for those who have tried other treatments without success. There are several types of surgical procedures, including urinary diversion, sling procedures, and augmentation cystoplasty, that can help with incontinence in women.

It’s important to note that no treatment is 100% effective all the type. Talk with your doctor about what you can expect with each treatment, as well as the pros and cons associated with them.

Urinary incontinence can have a big impact on a woman’s life and it’s important to get it treated.  Too many women live with symptoms of urinary incontinence, thinking it’s just a normal part of aging. But there are many treatments available and it can make life so much more enjoyable when you’re not looking for a bathroom or worried about having an accident. 

If you live with urinary incontinence, make an appointment with your doctor to talk about treatment options.  

Patient Perspective: Larry's Story

Larry's Story - Learning to manage my incontinence

I’m 68 years old and I have incontinence. I’ve suffered a lot of setbacks over the years. I lost a finger in the army. I suffer from high blood pressure. And I have an old football injury that flares up regularly. But I have never suffered as much shame and humiliation as I have since I started experiencing incontinence.

It started innocently enough - a leak here and there. My doctor said it was due to prostate problems and gave me some medication to help. It did for a while, but then the leaks flared up again and I was forced to admit that this problem was not going away.

My first trip to the grocery store to purchase incontinence pads was a doozy. Standing there, looking at the wall of options was so intimidating. What do I choose? What size? How do I know it will fit? What if it doesn’t – can I return the bag? I had so many questions and no one to ask – after all, it’s not like men just talk about peeing their pants with each other all the time. Not to mention I kept looking over my shoulder to make sure that no one I knew saw me standing there. It would be so embarrassing to be “caught” in this situation.

When I finally got home, I started trying out the various absorbent products that I had purchased. I had bought 3 different types and gave each one a fair shot for a full day before making the call. Unfortunately none of them worked so I was back to the drawing board.

Fortunately, my wife found a company online that sold different products so I gave it a shot. I don’t know why I didn’t start with this option in the first place. They offered a free consultation so I gave them a call. The rep was so helpful and it was great having a guide to walk me through the different options, and also learn more about me, my condition and my lifestyle to help find something that would work best for me.

These days, I only use online services to order absorbent products. And, I’ve found great products that help me keep my leaks controlled, and my condition under wraps so no one is the wiser.

I still don’t love having incontinence, but it’s become such a normal part of life now that it doesn’t have the same hold on me as it once did. I didn’t envision this happening to me, but am happy to know that there are resources out there to help and products available that can make it more manageable. I feel free to live my life without fear of leaks and that is something to be really proud of.

Larry B., Seattle, WA

Patient Perspective: Nick's Story

Nick's Story - Incontinence After Prostate Removal

In August of 2015, I underwent surgery to have my prostate removed.  I had been diagnosed with prostate cancer the year before and my doctor had been closely observing me since then. 

When it seemed that my cancer was growing more quickly than he liked, he suggested surgery.  “Afterall”, he said, “you’re only 63.  You can still have a long life without worrying about this.”

So, after a lot of research, I went for it.  I knew there would be complications afterward, but incontinence was not something that I had anticipated being that big of a deal.  I thought I’d probably have to wear diapers for a couple of weeks and that would be the end of it. 

Boy was I wrong. 

Nine months later and I was still having a difficult time making it to the restroom.  It was so embarrassing as a man to face this problem. I couldn’t do the things I wanted to because I was scared of having an accident or a leak, and I felt ashamed of the bulky diapers that I was forced to constantly wear. 

I finally made an appointment with a surgeon in May to discuss a sling procedure and will be having the procedure done next month.  I’m hopeful that this will be a solution for me so that I can get on with my life and get back to doing the things that are important to me. 

Nick W., Houston, TX

Patient Perspective: Ellen's Story

Patient Perspective - Ellen's Story of Living With Incontinence

After the birth of my 2nd child, I began experiencing urinary incontinence.  I started leaking a bit here and there, and it only got worse as I got older. I assumed it was just a part of aging and that there was nothing I could do. And while the episodes were embarrassing, I was able to control and hide them pretty well by wearing protection and always keeping a close eye on the toilet. 
 
However, when my youngest was 15 years old, I had my first real bowel accident, and life as I knew it officially changed.  I began having more and more episodes, and eventually didn’t even want to leave the house because I was so terrified of having an accident.  I stopped seeing friends. I ordered groceries and most things I needed online.  I refused to go on dates with my husband.  There is something that feels just a little bit worse about having a bowel accident vs. having a bladder accident – it’s messier, smellier, much more apparent, and just so humiliating that you never want others to know it is something you are going through.  
 
I lived like this for six years before finally realizing that I wasn’t controlling my ABL, it was controlling me.  I got up the nerve to speak with my doctor and was able to have a surgery that helped alleviate many of my issues. 
 
All of this could not have come soon enough – my first granddaughter was born a year ago and to think that I may have missed out on that moment or all the wonderful ones that have followed makes me cringe. My only regret is that I didn’t do something about it sooner.
 
Ellen T., Atlanta, GA

Patient Perspective: Sally's Story

Sally's Story - Running and working out when you have incontinence

Once both my kids were in elementary school full time, I finally started working out. I became a runner, and devoted most mornings after they were in school to jogging through the neighborhood. I entered races and started doing small 5Ks, until I finally worked my way up to a full marathon last year. Things were going great and I was feeling strong and happy.

So, imagine my surprise, after years of being an avid runner, to suddenly start experiencing bladder leaks. My kids were not little anymore – they were both in high school at this point and I thought that I bypassed this type of problem that usually accompanies childbirth.

I spoke to my doctor, and found out that, to my surprise, this problem often accompanies serious runners too. Turns out that pounding the pavement every day isn’t so great for your pelvic floor. In fact, my doctor told me that up to 30% of female runners experience incontinence while running.

My doctor said there are lots of things that can weaken the pelvic floor over the years; childbirth, age, and surgeries can all take their toll (I unfortunately check all three boxes). Add to that running several miles per week, and I saw how my activity was contributing to the problem. 

I wasn't ready to give up running, and luckily my doctor didn't think I had to. While there are many therapies available (medication, surgery, exercise), he started me on a regimen of kegel exercises. I do them first thing in the morning, and 3 other times throughout the day.  He also recommended that I try some other behavioral tactics: limit my fluid intake right before my run, make sure to empty my bladder before running, and try planning a route that has some bathroom stops along the way. 

These changes have been helping me a lot and while there might come a time that I consider something like surgery, for now, it helps to know that I’m able to take matters into my own hands and manage my bladder leaks without stopping the activities I love. 

I'm glad I opened up about this condition and can continue my passion!

Sally S., Atlanta, GA

Incontinence and Autism - A Treatment Guide

Incontinence and Autism
Incontinence and Autism

Incontinence is a condition that affects over 35 million Americans of all ages.  Dealing with incontinence can be difficult at any age, but helping a child with a disability, like autism, learn to manage incontinence can be especially challenging. 

As a child, learning to use the bathroom is a normal part of development. And even in children who don’t have a physical, mental or emotional disability, the rate at which they develop this skill varies greatly.  However, for some children with autism, other factors can play a part in how they learn to use the toilet.  Autism is a spectrum disorder brought on by a dysfunction of the central nervous system. It is usually diagnosed in the first three years of life. Children with autism experience impairment of common social skills (making eye contact, interacting with other people or reading social cues), communication difficulties (delayed language development or complete lack of speech), and behavioral challenges (sterotyped and repetitive body movements, extreme attachment to routines, unusually intense or focused interests, and sensory sensitivities to environments including sounds, light, smells and textures.

When looking at these characteristics of autism, it’s easy to understand how some children with autism may have challenges when potty training or learning to remain continent.

Using The 5 Ps.

 Incontinence may come in many forms, but there are some common ways to approach the situation. We call them ‘The 5 Ps,’ and they can help make treatment more tolerable for caregivers and contribute to a real opportunity for improvement:

Patience  

We all know that patience is a virtue, but when it comes to incontinence, it’s often a virtue that’s hard to find. Try not to place blame for setbacks. Instead, provide positive encouragement and do your best to maintain a good sense of humor – it’ll pay off in so many ways.

Persistence

Progress may be slow, but don’t give up. Having a positive outlook and setting sensible goals can reduce frustration for everyone.

Planning  

Incontinence is all about surprises, and they’re usually not pleasant ones! Take the time to schedule activities – even simple ones that you do around the house – and make sure to stick to that schedule. Communications planning is just as important – make sure that teachers, caregivers and anyone else who shares responsibility for the child knows what they need to know about the child’s situation and is able to take appropriate action if needed.

Practice

You never know what will work until you’ve tried it – and in most cases, that means trying and trying again. Test out different treatments, ask healthcare professionals for recommendations and see for yourself if there are certain products or programs that work for you.

Progress Is Possible

It may not always feel like you’re getting somewhere, but there are thousands and thousands of families who can tell you firsthand that the effort you make today really can turn into results down the road. It may not always be realistic to expect a cure, but there are things you can do – tactics, treatments and products – that can make your loved one much more comfortable and your life much easier.

It’s important to note that many children with autism have no problems with incontinence, and for those that do the severity of their condition can vary greatly. In addition, many children continue to develop over time and can improve their condition with the proper help and instruction from a caregiver. 

For more help on addressing incontinence in children with disabilities, download our brochure, Incontinence Support For Children With Disabilities.

ASK THE EXPERT: HOW DO I TALK TO MY LOVED ONE ABOUT INCONTINENCE?

How Do I Talk To My Loved One About Incontinence

Question: I’ve had a hard time discussing my father’s incontinence with him - he is so embarrassed by it and never wants to address it. How can I bring the subject up without making him uncomfortable?

Answer:  Caring for a parent with incontinence can be very hard.  After all, you’ve both played opposite roles for most of your life, with your parent providing most of the care for you. When a parent becomes dependent on their child, and especially when they are experiencing something like incontinence, it can make them feel ashamed and embarrassed. They may try to hard to hide their incontinence, or brush off mention of it and try to avoid the subject all together.

Start slowly. Discuss their health and condition and then talk to them about some of the incontinence symptoms you’ve witnessed.  Be patient - they may have some reservations in discussing their problem with you at first. But give them some time - once they feel comfortable, they’ll open up to you and you’ll be able to work on a management plan together.  

Tips For Managing Bladder Leaks When Traveling

Managing Bladder Leaks When Traveling

For the more than 25 million Americans with bladder control loss, leaving their comfort zone can be a daunting thought. It doesn’t have to be this way. With preparation and the right know-how, the anxious and uncomfortable feelings can be eliminated.

Imagine forgoing a golfing trip with your buddies or missing your favorite niece’s graduation because you will be in a situation where there may not be restrooms in sight. This is what many people with urinary incontinence and overactive bladder do. There are steps to take before your trip so that you are prepared for these situations.

First you should know how the medications you are taking affect your bladder function and body by asking your doctor about medications to help control urinary incontinence. Be aware that you will need to begin to take these medications weeks before your trip. Many people think of these medications as event management—take a pill when going out. But these medications need to be in the system for a couple of weeks for them to take effect. It is also helpful to get acclimated to the effects of a new medication, such as dry mouth or constipation, so that you can find ways to manage these side effects before going out of town.

Map out public restrooms in the city you are traveling to. There are online tools, mobile phone applications, and books devoted to this. 

Pack management tools. Absorbent products can be helpful in situations when loss of urine and bowel control is unpredictable. Pads, briefs, and absorbent underwear should be chosen for absorbency, comfort and fit. Visit the absorbent product section of NAFC’s website for more information.

Think about the travel it takes to arrive at your destination. While traveling you want to make it easy as possible to get to a restroom. If you’re traveling by airplane, get an aisle seat. And be sure to go to the bathroom before the drink cart heads down the aisle. You can also use online tools, such as Google Maps, to find rest stops along your driving routes, if you are traveling by car. Not every car on a passenger train has a restroom; perhaps you need to consider upgrading to business class or ask the reservation clerk for a seat closest to the toilet. And public toilets are often lacking supplies. Always have hand sanitizer, wipes, and pocket tissue handy.

While on vacation pay attention to what you are eating and drinking. Diet can have a profound effect on your voiding patterns. Stay away from caffeine, alcohol, and artificial sweeteners. These are known bladder irritants. Make sure you drink plenty of water. Many people who have bladder control problems reduce the amount of liquids they drink in the hope that they will need to urinate less often. Some fail to hydrate as they would like simply because they are in unfamiliar areas without beverages frequently accessible. While less liquid through the mouth does result in less liquid in the form of urine, the smaller amount of urine may be more highly concentrated and, thus, irritating to the bladder surface. Highly concentrated (dark yellow, strong-smelling) urine may cause you to go to the bathroom more frequently, and it encourages growth of bacteria.

Do not let your bladder control your life. If you are experiencing bladder control loss and you haven’t spoken to your doctor or healthcare provider about it you need to do so now. Help is available for everyone. More and more new treatments are successfully used for all types of incontinence. Improvement begins with you and continues through active participation in your treatment program.