Frequently Asked Questions: Female Incontinence
- What is incontinence?
- What are stress-induced incontinence or stress incontinence?
- What is urge incontinence?
- What are the causes of incontinence?
- What is known about the causes of urine leakage in women?
- How does incontinence impact quality of life?
- What can women do to ease the problems associated with stress incontinence?
- What can I expect when I visit my physician to discuss my incontinence?
- What can I do to better manage my incontinence?
- What are the available treatment options?
- Do any organizations address education needs in women (urinary incontinence)?
What is incontinence?
Incontinence describes the inability to control the passage of urine. It is actually a symptom, not a disease and can range in severity from an occasional, small amount of urine passing, to constant urine leakage, to a complete inability to hold any urine. Some people experience it at specific times: urine leakage during sex or other physical activity or when sneezing or laughing.
What are stress-induced incontinence or stress incontinence?
Stress incontinence (also called stress urinary incontinence – SUI) occurs when there is an increase in abdominal pressure. It can happen with physical activity or when you laugh, sneeze, or cough. The urine leaks due to weakened pelvic floor muscles or damage to the urethral sphincter. Ninety percent of those who have stress incontinence are women.1
What is urge incontinence?
Urge incontinence, a symptom of “overactive bladder”, occurs when you have a sudden, urgent need to go to the bathroom and you may not get there before urine leaks.
What are the causes of incontinence?
Each type of incontinence has its own causal factors. Stress incontinence in women can be caused by a variety of factors: multiple childbirths or menopause, being overweight, genetic weaknesses, radiation therapy or other chronic conditions. Urge incontinence (overactive bladder) is caused by damage to the bladder’s nerves, nervous system or muscles. Overflow incontinence is caused by weak bladder muscles, blockage of the urethra, or medical conditions such as tumors. Functional incontinence is caused by mental confusion associated with dementia or arthritis that slows the person’s ability to unbutton or unzip clothing or to get to the bathroom in a timely manner.
What is known about the causes of urine leakage in women?
Of the 137 million people worldwide who are suffering from stress incontinence, more than 90% are women.1 There are a variety of risks or contributing factors for stress-induced incontinence:
- Pregnancy and childbirth
- General loss of pelvic muscle tone
- Nerve and muscle damage as a result of injury or surgery
- Smoking and lung disease
- Chronic coughing
- Anatomical predisposition1
The majority of women suffer privately from incontinence for years, often waiting 3-10 years before seeking treatment.1
How does incontinence impact quality of life?
If you are struggling with urinary incontinence, you may experience changes in your behavior, emotions, social relationships, effectiveness in your job, and mental well-being. You may decide to reduce your fluid intake, wear incontinence panties or absorbable pads, switch from high to low impact exercise, or forgo active work or lifting moderate weight.
Emotionally you may feel that you’re no longer yourself, that you’re losing control and that you can no longer do the things you love to do. This can also impact your social activities if you are self conscious or embarrassed about possible odor. You may feel frustrated with your uncooperative body functions and view your treatment options as being limited, particularly if you don’t want surgery. Some people report feeling ashamed and suffer from lowered self esteem due to being incontinent.
It is important that you consider seeking help from a urologist or (uro)gynecologist. Many treatments options are available that may improve your symptoms and improve your quality of life.
What can women do to ease the problems associated with stress incontinence?
Most women mistakenly believe that stress incontinence is a normal part of aging. While that is not true, stress incontinence does primarily affect women ages 35 to 60 according to the World Health Organization.1
To help manage urinary incontinence more effectively, women may opt to wear special incontinence panties or incontinence pads. These manage the symptoms but will not take care of the problem.
For controlling incontinence after pregnancy (following childbirth) or other forms of incontinence, women can choose injectables, slings, or an implantable female urinary incontinence device such as the ACT device (Adjustable Continence Therapy, commercially available only outside the United States).
What can I expect when I visit my physician to discuss my incontinence?
About 80% of those impacted by urinary incontinence can be cured or improved.1 When you meet with your physician, you will provide your medical history and will be given a thorough examination. Your doctor may ask you many questions like:
- How long has the leakage been happening?
- How many pregnancies and what type of deliveries did you have?
- How often does leakage happen each day?
- Are you aware of the need to urinate beforehand?
- How much urine is leaking?
- Do you wear protective pads or garments? What kind and how often?
- How much does it impact your daily routine and your life?
- Do you experience urine leakage during sex?
- Is it more difficult to control when you cough, sneeze, strain or laugh?
- Is it more difficult to control when you are walking, running, or jumping?
- Are you constipated? And for how long?
- What medications do you take?
- Do you smoke, drink coffee or alcohol?
- Do you have diabetes or is there a family history of it?
- Do you have any other symptoms?
Diagnostic tests may also be performed:
- Urine culture to check for an infection
- Cystoscopy to inspect the inside of the bladder
- Urodynamic studies to measure pressure and urine flow
- Uroflow to measure pattern of urine flow
- Post void residual to measure the amount of urine after urination
- Q-tip test to measure the angle of the urethra at rest and when it is straining
What can I do to better manage my incontinence?
Fortunately, you can take the first steps to manage it by changing some behaviors and by retraining your body with specific exercises. These measures may be helpful:
- Increase fiber in your diet to avoid being constipated.
- Quit smoking to reduce coughing and bladder irritation.
- Avoid alcohol and caffeinated beverages which overstimulate your bladder.
- Avoid any foods or beverages that irritate your bladder.
- Closely monitor your blood sugar if you have diabetes.
- Lose weight if needed.
You can strengthen the muscles of your pelvic floor through bladder retraining or Kegel exercises. You can retrain your bladder by urinating on a schedule, whether you feel the need to go or not. You gradually increase your intervals by 30 minutes until you are only urinating every 3-4 hours without leakage. Kegel exercises require that you contract your pelvic muscles for 10 seconds at a time and then relax them for 10 seconds. You will do this 10 times in one session and repeat each session three times per day. The use of a vaginal cone may enhance the performance of Kegel exercises. Biofeeback and electrical stimulation can help you learn how to more effectively perform Kegel exercises2.
What are the available treatment options?
Treatment options vary according to your type of incontinence and the causes. Treatments can be categorized into three types: behavioral (those noted in the above FAQ), pharmacological, and surgical.
After a physical examination, your physician may recommend medications or drugs for treatment of stress incontinence or other types. These can help control incontinence or the doctor may opt to take you off a drug or medication that may contribute to your symptoms.
View information on ACT®, a surgical treatment for urinary incontinence in women commercially available only outside the United States. Other options include injectables and “slings”.
Do any organizations address education needs in women (urinary incontinence)?
Several well-respected physician organizations (in the areas of urology or Urogynecology) provide useful and credible information about urinary incontinence. Consumer advocacy organizations that offer information about urinary incontinence, incontinence products and services, and can help you identify a physician who specializes in treating urinary incontinence.
If you’d like to connect with others, there are also additional links to other informational sources and online support groups on our Incontinence Resource Center.
For patients outside the United States: Learn more about ACT® as a treatment for urinary incontinence in women.
1 Worldwide Estimates of Current and Future Individuals (>20 years) with Lower Urinary Tract Symptoms Including Urinary Incontinence and Overactive Bladder. Kopp Z et al. presented at International Consultation on Incontinence, Paris July 5-8, 2008.
2 Greenstein M. Medical Encyclopedia; Urinary Incontinence. 23 July 2007. Medline Plus. Nov 2007.
3 Urinary Incontinence & OAB Health Center. 2005-2007. WebMD. Nov 2007.
4 Sobol, J. A New Treatment for Male Stress Incontinence. 29 Aug 2007. IncontinenceNetwork.com. Nov 2007.
—This page last modified Wednesday October 22, 2008