Urinary Incontinence Causes in Females and How to Manage It

Imagine finding yourself laughing with friends or lifting something heavy, only to feel an uncontrollable leak. 

For many women, this isn't just hypothetical, it's the reality. Urinary incontinence is often brushed under the rug due to embarrassment. But, it affects millions of women worldwide, disrupting their confidence and quality of life.

But here’s the good news: this common condition is manageable, and in many cases, treatable. In this article, we're going to highlight the causes of urinary incontinence and outline a range of effective treatment options. We want women to be able to regain control and break free from the stigma associated with urinary incontinence.

What is Urinary Incontinence?

Urinary incontinence is defined as urine leakage from the bladder. There are various causes of urinary incontinence but weak pelvic floor muscles are a major risk factor.

The reality is, urinary incontinence in women is very common. It primarily affects those over the age of 50, but it can affect younger individuals as well. But, regardless of age, urinary incontinence is often seen as an embarrassing problem, and it can significantly impact daily life.

Types of urinary incontinence

Medical professionals consider there to be 4 different types of urinary incontinence:

• Stress incontinence: This type of incontinence occurs during movements that put pressure on the bladder. For example, during exercise, coughing, sneezing, laughing, or lifting heavy objects.

• Urge incontinence: Also known as urgency incontinence. This type of incontinence is defined as feeling a frequent need to pee or the inability to hold it long enough to reach the toilet.

• Mixed incontinence: This is a combination of both stress incontinence and urge incontinence.

• Overflow incontinence: This is when the body produces more pee than the bladder can handle. This leads to an overflow of urine.

According to Bladder and Bowel UK, urinary incontinence affects 1 in 10 people, and women are disproportionately impacted due to additional risk factors like anatomical and hormonal differences.

Although urinary incontinence is common, unfortunately, there's still a stigma around it. People rarely talk about the problem, with most people assuming the only option is to accept it and carry on. However, we're here to tell you this isn't the case. Urinary incontinence is manageable.

Ways to Prevent Urinary Incontinence

Preventing urinary incontinence in women involves adopting healthy lifestyle habits and taking proactive steps to maintain pelvic floor health. Here are some strategies:

• Stay Physically Active: Regular exercise improves muscle tone, including those supporting bladder control such as pelvic floor exercises, pilates or even belly-dancing and hula-hooping.

• Maintain a Healthy Weight: Reducing excess weight will lower the pressure on the bladder. Of course, this has a double benefit and leads to an overall improvement in health.

• Adopt a Balanced Diet: If necessary, avoid bladder irritants like caffeine, alcohol, and acidic foods. It's also important to stay hydrated without drinking in excess.

• Quit Smoking: Smoking can lead to chronic coughing, which weakens pelvic floor muscles over time.

Causes of Urinary Incontinence in Women

For women, there are a range of causes of urinary incontinence. These include physical risk factors, hormonal changes, and lifestyle-related concerns. But, the cause can also be linked to stress and certain medical conditions.

Damage to pelvic floor muscles

Pregnancy and childbirth: During pregnancy, there are a range of hormonal changes as well as increased pressure on the bladder and pelvic floor. When giving birth (particularly vaginal birth but also C-sections) you may damage and weaken pelvic floor muscles and nerves around the bladder. Both of these things commonly lead to stress incontinence but we have some helpful tips for expectant mothers.

Surgery or injury: Surgeries in and around the pelvis, like a hysterectomy, can damage delicate pelvic nerves which control bladder function. This can sometimes lead to involuntary leakage from the bladder.

Hormonal and age-related changes

Menopause and hormones: During menopause, oestrogen levels drop and lead to a thinning of the urethral lining. This means that women are often unable to hold urine and feel the urge to urinate more frequently.

Age-related muscle loss: As women age and as a result of menopause, they tend to lose muscle mass around the body. This also weakens the muscles that prevent the loss of urine. But, menopause doesn't have to change everything and there are activities to improve bladder strength.

Lifestyle factors

Obesity: As with other health conditions, obesity increases the risk factor. In this case, the increased body weight puts added pressure on the bladder and pelvic muscles.

Dietary triggers: Some foods and drinks can irritate the bladder, for example, caffeine and alcohol. Typically, when consumed in excess, caffeine and alcohol increase the urge to pee. If urinary incontinence is an existing problem, these substances can exacerbate it.

Smoking: For smokers who cough a lot, this chronic coughing can impact pelvic floor muscles and lead to incontinence.

Physical inactivity: Those who are physically inactive are likely to have some muscle wastage. This is a contributing factor to poor bladder function and stress incontinence.

Medical conditions that contribute

Urinary tract infections (UTIs): UTIs can be more common in those experiencing urinary incontinence, but they can also be a cause of incontinence as well. Frequently recurring UTIs contribute to problems with bladder lining, nerve function, and weakened pelvic floor muscles.

Neurological disorders: Neurological diseases and disorders can impact bladder control. multiple sclerosis, Parkinson’s disease, and strokes are prime examples.

Diabetes: Poorly managed diabetes can lead to nerve damage which increases the risk of incontinence. Those living with diabetes also experience polyuria.

Psychological causes

Stress and anxiety are major contributing factors for many health conditions. Urinary incontinence is no different. Anxiety can worsen an overactive bladder, where the person feels the need to pee more frequently.

The good news about urinary incontinence is that it's manageable, and in some cases a return to a normally functioning bladder is possible.

Diagnosis for Urinary Incontinence

First and foremost, urinary incontinence should be diagnosed by a medical professional. If you experience any of the above types of urinary incontinence, seek medical advice. Always have urinary incontinence diagnosed and treated by your GP.

Diagnosis may include some tests like a urinalysis or ultrasound and a bladder function diary.

Urinalysis: This identifies any possible infection that could be causing inflammation and incontinence.

Ultrasound: Detects structural abnormalities or blockages.

Bladder diary: This will track fluid intake, urination frequency, and leakage incidents. Patterns can help pinpoint triggers. We offer a free bladder care diary that you can complete in the 3 days prior to your initial doctor's consultation.

Common treatment options

Once your doctor has identified the underlying cause and ruled out anything serious they will prescribe a treatment plan.

Treatment options will vary from person to person depending on the diagnosis. But, we can give you insight into the various treatment options available.

Stress incontinence

• Pelvic floor muscle training exercises: Kegel exercises are commonly recommended for stress incontinence. These exercises involve repetitive clenching and releasing of pelvic floor muscles to strengthen your pelvic floor. Pelvic floor training is best

• Lifestyle changes: Increasing physical activity is beneficial for overall strength and health. This is often recommended in combination with other treatment options.

• Behavioural techniques: Bladder training techniques help re-wire the brain-bladder connection. This helps to increase the time between needing to pee.

• Medications: Hormone replacement therapy (HRT) may aid in strengthening muscles and tissues weakened by menopause.

• Medical devices: In order to prevent urine leakage special medical devices can be inserted such as sacral nerve stimulation therapy

• Surgery: Certain procedures can be performed particularly for stress incontinence and this may also involve repairing pelvic organ prolapse.

Urge incontinence

• Behavioural techniques: Techniques like "double-voiding" and pee scheduling are considered effective. "Double-voiding" is when a person passes urine immediately after the first attempt. This ensures the bladder is completely empty. Bladder retraining s is a way of conditioning or training the body to develop a greater ability to hold pee. Bladder retraining should be done under the supervision of a healthcare professional for best results.

• Lifestyle adjustments: Diet or lifestyle choices can lead to urge incontinence. Your doctor may recommend increasing physical activity and adjusting your diet. To get you started we have a day of bladder-friendly and healthy recipes. Hydration management is another critical component. It's advised to avoid excessive consumption and not to drink fluids close to bedtime.

• Medications: Certain medications are effective at calming an overactive bladder to reduce urge incontinence, as with all medications there are potential side effects so it is important to be aware.

• Bladder procedures and therapies: Therapies like electrical stimulation can be very effective at improving nerve function.

Overflow incontinence

• Medical devices: Urethral inserts and pessaries can be used to physically plug the urethra. They also act to support the urethra and prevent urine leakage. Plus, catheters can be inserted to collect urine.

• Surgery: If overflow incontinence is a result of a structural abnormality, surgical intervention may be the best choice.

• Behavioural therapies: Similar conditioning and bladder training techniques used for other types of incontinence can be used to manage overflow incontinence.

In general, each treatment plan is tailored to the individual. Your healthcare provider will typically recommend a combination of behavioural strategies, medical interventions, and/or lifestyle adjustments. In many cases, surgery is unnecessary and generally considered a last resort. Yet, where chronic urinary incontinence occurs, it may be required.

It's important to recognise that urinary incontinence doesn't have to control your life. It is possible to regain the same confidence and quality of life you once had.

Managing Symptoms of Urinary Incontinence

In the event that treatment doesn't completely fix the problem, we offer various solutions and products to manage the problem. Pads, liners, and leakproof pants are most commonly used to absorb small amounts of urine leakage. In more serious situations, a catheter can be used to collect urine.

Support groups and counselling can also help women cope with the emotional impact of incontinence. Joining a community of others experiencing similar issues can reduce feelings of isolation. Additionally, engaging in activities that promote relaxation can help reduce stress levels. Yoga or meditation are particularly popular.

Finally, regular physical activity provides excellent overall health benefits. These benefits go beyond improving pelvic floor muscles. Simple changes like maintaining a healthy weight and staying hydrated can make a big difference.

Final Thoughts

While urinary incontinence is a challenging and often embarrassing condition, it's not one that women need to suffer in silence. Following approved treatments can help manage and even eliminate this condition. Open conversations and early interventions are key to breaking the stigma, and ensuring women regain control and confidence in their daily lives.

FAQs

Is urinary incontinence a symptom of perimenopause?

Perimenopause is the beginning of hormonal changes leading to menopause. Because of a gradual decrease in oestrogen, the pelvic muscles and urethral tissues start to thin which can lead to urinary incontinence.

What food and drinks should be avoided when managing urinary incontinence?

Avoiding excessive consumption of caffeine and alcohol is a good start. Caffeine and alcohol are known diuretics which increase the production of urine. Other drinks loaded with artificial sweeteners, like fizzy drinks, are also best avoided.

Regarding foods to avoid, this can vary from person-to-person. However, citrus fruits, tomatoes, and acidic food are all commonly reported to irritate the bladder.

Why do I feel the urge to pee when I'm stressed?

Stress usually shuts down things like digestion but the bladder doesn’t always get the same treatment. Hormones like adrenaline can make bladder muscles overactive thus making you feel the urge to pee when you are acutely stressed.

We may have evolved to empty the bladder to “lighten the load” in a dangerous situation. The flight or fight response is a common human response to perceived threats.

Anxiety can also make you more aware of bodily sensations which can make the urge feel stronger.