By Roy Epstein, M.D.
Hallmark Health Medical Associates
Dr. Epstein treats women of all ages for women’s health concerns, including incontinence.
Cough, sneeze, laugh, or move – don’t forget to cross your legs! If this is a daily occurrence in your life, you’re far from alone. Approximately 60 percent of women will experience some amount of bladder leakage – incontinence – in their lives.
This problem is very common, but many women often are uncomfortable talking about it even with their close friends – and certainly not with their physician! It’s not just a normal part of aging, right?
Women think bladder leakage is unavoidable, but it doesn’t have to be. We can treat it with the proper diagnosis. Let’s look at the most common issues women face.
Types of urinary incontinence in women
The first step in treating urinary incontinence is determining which type of incontinence the patient is dealing with. These are the four most common types of bladder trouble we see in our patients:
- Stress incontinence: This is the most common incontinence issue we treat in our office. Women who deal with stress incontinence lose urine when they laugh, cough, sneeze, or move. This condition is common after childbirth, but it can happen to any woman as she ages.
- Overflow incontinence: This condition occurs in women who lose urine while sitting or lying still, without added pressure from movement or coughing. The bladder does not empty properly, and urine dribbles out involuntarily. Urge incontinence is especially frustrating because there is typically no warning that a leak is about to occur.
- Urge incontinence: This frequently happens when you are at the front door, trying to get the key in the lock and you get a strong, sudden urge to urinate, and you can’t make it to the bathroom in time.
- Other: Urinary tract infections and menopausal changes may also cause urinary incontinence.
Some patients deal with a combination of these four conditions. The symptoms range in severity from occasional incidents to daily or nightly occurrences. Along with bladder leakage, some women experience irritation or infection on the outside of the vagina (the vulva) due to excess wetness and wiping with toilet paper.
Emotional and social symptoms also can affect some patients’ quality of life, such as being afraid to leave the house or take a road trip for fear of accidents, or worrying about whether others can tell that they are wearing pads or absorbent undergarments.
Why is urinary incontinence so common in women?
Women tend to have more difficulty than men with urinary incontinence, primarily due to childbirth. Everything in the pelvic area gets stretched during pregnancy and delivery. Women tend to associate bladder leakage with vaginal deliveries, but we see patients who’ve had C-sections and still have urinary incontinence.
The tube through which you urinate (the urethra) has a sphincter (a ring-like muscle) that squeezes when you laugh, cough, sneeze, or move to keep urine from leaking out. Childbirth can cause trauma to the pelvic area and sometimes the sphincter is damaged.
We also see many women with no history of childbirth who experience urinary incontinence. It’s no secret that our bodies change with age, and that includes changes in the pelvic area. The muscles and mechanisms that worked well earlier in life can start to wear down and work less effectively over time.
Treatment for incontinence is available
Women often don’t feel comfortable bringing up these personal symptoms, or may think it’s a normal part of life. In my practice, we screen all women with a short incontinence survey, no matter why they come see us. Women can rate their struggle with incontinence on a scale of 1 to 10, if they choose. It’s an effective way to bring it up delicately without embarrassing the patient.
Many women have just a little incontinence from time to time, and it doesn’t really affect their lives. These women often opt not to seek treatment for their condition, and that’s totally fine.
But if you are afraid to stray too far from home without access to a bathroom or if you can’t participate in your favorite activities without having an accident, we have many treatment options to help you regain your quality of life. Your doctor can help you figure out the appropriate treatment method for your specific urinary incontinence problem.
Check back for next week’s blog, in which I’ll discuss the various treatment methods we have available for women who suffer from urinary incontinence, including physical therapy in our Pelvic Care Center.
Tags: incontinence, women's health