What Causes Incontinence In Women?

What Causes Incontinence In Women_.jpg

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.  

What Is A Pelvic Floor PT And How Can One Help Me?

What Is A Pelvic Floor Physical Therapist And How Can One Help Me?

Barbara Jennings was 6 weeks postpartum when she realized that something wasn’t right. “I had been feeling some pressure in my vagina for a while, but figured it was just a part of the normal healing process after vaginal delivery.” When she finally got the courage to explore a bit, she found something that surprised her. “I felt a smooth lump protruding slightly from the opening of my vagina. I was horrified, and so scared!” 

What Barbara was experiencing is called a pelvic organ prolapse, and it’s not uncommon. A prolapse happens when the vaginal walls become too week (due to things like childbirth) and the organs that are supported by them fall into the pelvic floor basket, sometimes protruding from the vagina. It’s not a curable condition, but can be improved by behavioral modifications, or surgery if necessary.

“After doing a lot of research, I learned that physical therapy could be done to help strengthen the muscles of the pelvic floor and improve symptoms of prolapse”, said Barbara. “I had never even heard of physical therapy for that part of the body, but because I knew I didn’t want surgery, I signed right up.”

Women’s Health PTs are a thing, and they treat everything from prolapse, like Barbara experienced, to pelvic pain, incontinence, back pain, diastasis recti, and more.  But how do you know if you need one? And at what stage of life do you see them?

The first thing to know is that you can see a Woman’s Health PT at anytime. Whether you’re feeling some back pain during pregnancy, want to get checked out after baby arrives, or have difficulty picking up your grandkids without leaking, physical therapy is an option.  Improvements can be seen at any age, and most physical therapists would agree that it should be a first line of defense against leaks and pelvic floor disorders. 

Medications and surgery are often thought of first when it comes to treatment, but when you commit to a physical therapy routine, you’re making the effort to strengthen your body yourself, which can alleviate a lot of pain and/or leakage on it’s own.  If you’re experiencing any kind of pelvic floor, back or hip pain, or if you have bladder leaks, call a physical therapist and get set up an appointment for an examination.

So, what can you expect when you visit? As with most doctor’s visits, you’re PT will ask you lots of questions about your medical history, and the symptoms you’re currently experiencing. You’ll also likely get a musculoskeletal evaluation, and if you are experiencing any pelvic floor dysfunction, an internal exam.

The internal exam sounds scarier than it actually is – rest assured your PT has performed many internal exams and there is nothing to be embarrassed about. It’s a necessary step for them to determine the state of your pelvic floor muscles, and your treatment plan.

Multiple visits are usually required to assess your improvement over time, and to ensure that you are performing your exercises correctly. Treatment is considered complete when your symptoms have improved, although you may need to continue with your treatment plan even after you stop visiting your PT.

If you experience any type of pelvic floor related dysfunction, including pain, bladder leaks, or even if you experience back pain (those muscles are all connected after all!), don’t hesitate to see a PT. It’s often a good first line of defense for these issues and may resolve them better and more naturally than medications or surgery. “Even though my prolapse will never be completely “cured”, I have seen tremendous improvement in my symptoms since I started physical therapy”, says Barbara. “I’m so glad I looked to this option first.”