Fibromyalgia And Incontinence: What’s The Link?

Fibromyalgia (FM) is a condition that is often associated with pain, muscle weakness, fatigue, and even sleep problems. But one symptom that isn't commonly discussed is incontinence. In fact, for plenty of women living with FM, incontinence (both faecal and urinary) is an incredibly frustrating reality.

The exact cause of fibromyalgia isn't fully understood and similarly, the link between this condition and incontinence is multi-faceted so, let's take a look at why FM can sometimes cause incontinence.

The Connection Between Fibromyalgia And Incontinence

Fibromyalgia is a complex condition that can affect women in a number of ways. Unfortunately, some women may find that they have symptoms that extend beyond the 'typical' symptoms of FM and also cause uncomfortable bowel and bladder symptoms.

But what exactly causes the link between fibromyalgia and incontinence? Well, there are a few factors that you may need to consider if you're living with FM and experiencing the discomfort of bladder problems.

These include:

Nervous system dysfunction

One of the most prevalent symptoms of FM is central nervous system dysfunction. Because of this, one of the hallmarks of FM patients is a heightened sensitivity to pain (known as central sensitisation).

But what does that mean?

Well, it means that the brain and spinal cord process pain signals in a more exaggerated way. This can lead to pain and discomfort—even from things that wouldn't normally be painful.

This hypersensitivity can also spread to other areas of your body, including nerve signals that control your bladder function. In some women, this may lead to overactive bladder symptoms, including increased urinary frequency and the sudden and uncontrollable urge to pee.

Pelvic floor muscle weakness

Your pelvic floor muscles are super important for supporting your bladder and bowel. However, women with FM often suffer from muscle weakness, stiffness and fatigue, which can affect their pelvic floor muscles.

When these muscles become weaker, it can cause you to have less control over your bladder and bowel movements. This is one of the main reasons why stress incontinence (where pressure is placed on your bladder through certain activities) may be common in women with FM.

Additionally, with less control over your bowel movements, fibromyalgia can also lead to faecal incontinence.

Because of all of this, women who suffer from FM usually find that their symptoms aren't only painful but also affect their confidence and quality of life.

Fortunately, in some cases, pelvic floor exercises like Kegels can help strengthen your muscles again. In turn, you can regain some control over your bowels and bladder and feel more like yourself again.

Just remember that exercises like Kegels should always be overseen by a pelvic floor physiotherapist or women's healthcare provider. This is why it's best to consult your medical team before starting any new treatment regime.

Coexisting medical conditions

While fibromyalgia incontinence is common, patients who have been diagnosed with FM may also experience other symptoms that worsen these urinary symptoms. Some of these conditions can include:

• Irritable bowel syndrome (IBS): Irritable bowel syndrome is a digestive disorder that can cause unpleasant symptoms like pain, bloating, diarrhoea, and constipation. And, if you're already experiencing faecal incontinence as a result of your FM, then your symptoms may be more severe. This is particularly true when your bowel movements become unpredictable.

• Interstitial cystitis (IC): This chronic bladder condition causes pain, urgency, and frequency, often mimicking a UTI.

• Endometriosis: Endometriosis usually occurs when tissues similar to the lining of your uterus begin to grow on other organs outside the uterus. When this tissue grows on your bladder or bowel, it can lead to symptoms like pain when you pee, urinary urgency, and incontinence.

Types Of Incontinence Linked To Fibromyalgia

Although incontinence is common in women with fibromyalgia, it's not a 'one-size-fits-all' kind of deal. Instead, incontinence can take different forms and have different symptoms. So, to be able to narrow down what exactly it is that you're experiencing, it's good to know how to differentiate between the different types.

Remember: If you're experiencing any of these types of incontinence (with or without an FM diagnosis), it's important to speak to your GP. They can help you find the best way to manage your symptoms and explore different treatment options that will work for your specific situation. With the right support, you can easily handle your symptoms and get your quality of life back.

Stress incontinence

Stress incontinence occurs when you leak pee during activities that put pressure on your bladder, such as sneezing, laughing, coughing, or lifting anything heavy.

If you have fibromyalgia, your pelvic floor muscles may already be weaker, and you may struggle to hold your bladder at the best of times. But, when it's coupled with stress incontinence, it can be almost impossible to avoid uncomfortable leaks.

Urge incontinence

This type of incontinence is usually noticeable because it causes a sudden and strong urge to pee without any warning. Of course, this can be difficult to control.

Urge incontinence happens when your bladder muscles contract too often, even if your bladder isn't full. Typically, these contractions only happen when your bladder is ready to release. So, when it starts to contract, those urges to run to the loo will be just as strong as if your bladder were actually full.

Since fibromyalgia affects the nerves, your bladder may also feel painful and irritated, which can mimic the same sensitivity felt with urinary tract infections. This sensitivity can make it feel as though your need to pee is more urgent than it actually is.

Nocturia

If you wake up frequently at night to go and pee, this is known as nocturia. And if you have FM, this may be even more annoying since you're likely already dealing with sleep disturbances and chronic fatigue.

Usually, when you're asleep, your brain and bladder send fewer signals to one another to alert you that your bladder needs to be emptied.

However, your FM pain may cause you to wake up periodically anyway, which wakes your brain and your bladder up, too. In turn, you're more likely to feel as though you need the loo.

If you're already struggling with incontinence, this may play a role, too. For some women with urinary incontinence, their need to pee may heighten at certain times throughout the day—and nighttime is no exception.

FAQs

Can pain cause incontinence?

Pain can sometimes cause incontinence, especially if it's related to FM. This is because your body's heightened sensitivity to pain can cause your bladder to become overly sensitive. Similarly, the usual discomfort of a full bladder may instead feel painful and cause your bladder to become overactive.

In some cases, pain can also trigger muscle spasms in your bladder and pelvic floor, which can lead to leaks.

What is the difference between bladder leakage and incontinence?

Although bladder leakage and continence are similar the main difference lies in how the terms are used. Bladder leakage is often used in everyday language while incontinence is the more medical term. Both refer to the loss of bladder control, but incontinence is typically used in clinical settings to describe a persistent condition.

Some women may prefer the term “leakage” because it may feel less stigmatising than “incontinence” although both can describe the same issue.

How can I manage my fibromyalgia incontinence?

Besides working on a treatment plan with your GP to treat the root cause of your incontinence, there are plenty of helpful ways to manage your symptoms.

If you are looking for bladder support post-menopause, you may want to check with your GP about whether bladder care supplements could be an option for you. Alternatively, you can use incontinence pads or leak-proof pants to help keep you comfortable and dry throughout the day.

Final Thoughts

While incontinence is an uncomfortable condition to live with at the best of times, pairing it with the existing pain and discomfort of fibromyalgia can seem like a nightmare.

However, it's important to remember that you're not alone. Instead, with the help of your GP or a women's health specialist, you can come up with a treatment plan to ease your symptoms.