Urinary Incontinence in Women

Incontinence in women at a glance

• Female incontinence is a symptomatic response to weekend pelvic floor muscles that results in the unintended release of urine.
• Women experience incontinence at a much higher rate than men because of life events such as pregnancy, childbirth and menopause.
• Primary variations of urinary incontinence in women include stress, urge and mixed.
• Incontinence treatment options for women range from lifestyle changes that retrain the bladder to surgical procedures that reinforce the pelvic wall.

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What is incontinence in women?

Incontinence is inadvertent urine leakage that affects millions of women in the U.S. During normal urination a woman’s bladder muscles contract while the sphincter muscles around the urethra relax, allowing the urine to exit the body. If a woman’s sphincter muscles aren’t strong enough to hold back the urine, she has incontinence.

The primary types of incontinence in women include:

• Stress incontinence — Occurs when the bladder releases urine after experiencing pressure due to a sneeze, cough, laugh or other physical activity such as running.
• Urge incontinence — Classified by having a sudden and severe need to urinate.
• Mixed incontinence — Includes both stress and urge incontinence symptoms.
• Overflow incontinence — Occurs when urine is blocked from flowing normally out of the bladder. This can cause the bladder from never fully emptying.

Women experience incontinence twice as frequently as men primarily due to pregnancy, childbirth and menopause. Pregnancy causes hormonal changes and as the uterus increases in weight, the organ may put pressure on the bladder and lead to stress incontinence. Childbirth, especially vaginal delivery, weakens the muscles required for urine control, such as the sphincter, and may contribute to incontinence symptoms. Menopause drastically decreases estrogen production, which normally keeps the urethra and bladder lining healthy and strong.

Women with medical conditions such as Alzheimer’s disease and others that interfere with physical movement, communication and thinking may experience a type of incontinence called functional incontinence. All forms of urinary incontinence may form in both men and women.

Causes & symptoms of incontinence in women

Incontinence itself is not a syndrome or condition, but rather a symptom of underlying weak urinary tract muscles or damage in the urinary tract or the nerves that control urination. Childbirth or weight gain may contribute to stress incontinence. Urge incontinence may be governed by more inherent factors such as emotional stress, brain damage or neurological diseases like Parkinson’s.

Other factors that may cause temporary incontinence in females include:

• High alcohol and caffeine intake
• Eating spicy, surgery or acidic foods
• Carbonated drinks and artificial sweeteners
• Muscle relaxants, sedatives or heart and blood pressure medications.

Treating incontinence in women

There are a number of treatment options for women experiencing incontinence. Typically, women start with more conservative treatments before considering more dramatic treatment such as a surgical procedure.

Lifestyle changes

Making lifestyle and behavioral changes helps women retrain their bladders and strengthen urinary muscles. Minimizing alcohol and caffeine throughout the day, along with reducing overall fluid intake in the evening, should improve minor and temporary symptoms of incontinence.

Bladder training consists of delaying urination after the initial urge arises and slowly increasing the wait time before voiding. Double voiding, the practice of urinating and then waiting another minute before urinating once more, ensures the bladder empties completely when urinating. Setting up a bathroom schedule throughout the day also helps regulate urge incontinence.

Strengthening the pelvic muscles by performing Kegel contractions strengthens the supporting muscles of the bladder and urethra in order to function normally. To perform a Kegel, tighten the muscles used to stop urinating and hold in for five seconds, followed by relaxing for five seconds. Women should aim for at least three sets of 10 Kegels every day. Women may also try biofeedback therapy, a method that teaches women how to identify their pelvic floor muscles by using computer graphs and audible tones to identify muscle contraction and release.

Medication, surgery or catheterization are other possible treatments for female incontinence, and are typically explored once conservative treatments fail to produce acceptable results. Medications generally relax the urinary muscles and are most commonly used to treat urge incontinence, while surgery and catheterization devices such as vaginal slings treat stress incontinence. These devices are surgically inserted through the vagina and help close the edge of the urethra so that a woman may hold back her urine.

Discuss Treatment Options Meet Our Female Urology Specialist