We want to break down the basics of stress incontinence. But if you brace yourself for every sneeze or don’t trust running because of the time when you peed through your leggings, you already know what we’re talking about.
What is stress incontinence, exactly? It means that you might involuntarily pee a little when you do things like cough, sneeze, laugh, run, have sex, bend over, lift something heavy, or do anything that puts physical stress on your bladder. While the term includes the word stress, it is not caused by psychological stress (although we could definitely argue that it causes some angst!) As women get older, especially during or after pregnancy, experiencing these bladder leaks is super common, affecting at least one in three women overall and one in two women over the age of 50.
So, why is it more likely to happen as we age or with pregnancy/childbirth? As we’re growing wiser (or growing a baby), the pelvic floor muscles that support the urethra tend to get weaker and don’t have as much control over the release of urine. That means when your bladder is under stress, the urethra doesn’t always hold up its end of the deal.
Let’s do a little anatomy recap. The bladder is where urine is stored until you release it and is made of elastic tissue that can expand as it fills up with liquid. The urethra is the tube that carries urine out of your body from your bladder and is surrounded by muscles that keep it closed and stop leaks.
Generally, the muscles surrounding your urethra stay closed as your bladder fills up, allowing you to wait to release the urine until you find a restroom. When these are weakened, anything that puts force on those muscles can cause you to spring a leak. Pregnancy and delivery weaken the pelvic floor muscles, which is why many healthcare providers recommend Kegels. Other causes of pelvic floor muscle weakening include chronic coughing, aging, obesity, smoking, or doing a lot of high-impact activities over the years. We also know that certain health conditions can cause stress incontinence. 40% of women with diabetes and 80% of women with MS experience bladder leaks, as do 52% of women undergoing gynecological cancer treatments.
If you think you’re experiencing stress incontinence and it’s disruptive to your life, talk to your doctor. They may do a neurological exam, urine test, and/or a urinary stress test. Your doctor may recommend pelvic floor muscle training (AKA Kegels) to help you re-strengthen the muscles that make up your pelvic floor. They may also suggest cutting back on fluid intake or making lifestyle changes such as quitting smoking or losing weight. Cutting down on alcohol and caffeine may also help.
There is not currently an FDA-approved medication to treat or prevent stress incontinence, but sometimes people who experience severe stress incontinence have a procedure called bladder sling surgery that is intended to help keep the urethra closed during activities that might cause urine leakage (We wrote a whole article about it here!). Your doctor could also recommend a bladder neck suspension, which lifts the bladder toward the pubic bone with permanent stitches, or bulking agent injections which bulk up the inner urethral lining to help stop leaks. Your doctor is the right person to ask about these treatments.
For many of the millions of women who experience stress incontinence, infrequent leaks during specific activities are a minor setback easily managed with high-quality incontinence pads. With today’s products for everything from a tiny dribble to a big splash, there’s no reason to let stress incontinence keep you on the sidelines. So stock up, pick your head up, and meet us at the trampoline!
Sources
The Mayo Clinic
Urology Health
Mayo Clinic Health System
Disclaimer: This content is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This content is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.