Loss of bladder control, known medically as urinary incontinence, is an issue that affects many women, often more than we realise.
A recent study from researchers at RUSH, published in the January edition of the journal Menopause, shines a light on this condition that impacts up to 50% of women, highlighting its possible connection to serious health consequences like disability.
Dr Sheila Dugan, Department Chair of Physical Medicine and Rehabilitation at RUSH, stresses the importance of early intervention. She explains that urinary incontinence is not something women should accept as inevitable.
"The study suggests that urinary incontinence is associated with disability, and therefore, seeking treatment early on may reduce the risk of this outcome in midlife women," Dugan said.
The research breaks down incontinence into stress incontinence, which includes urine leakage during actions such as sneezing or coughing, and urge incontinence, where there is a sudden need to urinate.
There's also mixed urinary incontinence, which is a combination of both stress and urge incontinence.
When discussing the mechanics behind stress incontinence, Dugan said: "When you sneeze or cough, there is a mechanical pressure from your belly that overwhelms the sphincter, leading to leakage."
Meanwhile, for urge incontinence, women experience an intense urge to urinate, often when they are near a bathroom.
RUSH researchers evaluated how often and how much women were affected by these conditions and their findings suggested that those with mixed incontinence and frequent, larger amounts of leakage were more likely to face disability issues.
They used the World Health Organization's disability assessment scale to measure the impact of incontinence on daily life.
According to Dugan, who helped establish the Program for Abdominal & Pelvic Health at Rush, every patient requires a tailored approach.
The programme evaluates women individually to uncover the underlying causes of urinary incontinence and to discuss possible treatments.
This personal attention is critical because effective solutions can vary widely depending on the type and severity of the condition.
In simple terms, if you're one of the many women dealing with urinary incontinence, it's not something you just have to live with. Options are available and finding help early can potentially improve your quality of life and well-being.
For example, muscles are checked to uncover whether tight bands in the muscles are causing incontinence or whether weak muscles are to blame.
"In a case of tight muscles, a woman may try to tighten the muscles further with more exercise, not knowing that it may make the incontinence worse," Dugan said.
"Pelvic floor muscles support pelvic organs and organ problems can lead to muscle problems or vice versa. One patient may have incontinence due to hip arthritis, another from a difficult delivery, or it can be caused by cancer treatment, for example, radiation in the pelvic area."
There are a number of potential causes, or even a combination of causes, of incontinence.
The data used was from a larger clinical trial called SWAN (the Study of Women Across the Nation) that included more than 1 800 participants.
SWAN was initiated in 1994 with seven sites across the US to identify changes that occur during the menopause transition in mid-life women and their effects on subsequent health and risk for age-related diseases.
Who gets urinary incontinence?
These conditions primarily affect women, especially as they age, with many women over 65 experiencing it.
Why does urinary incontinence affect more women than men?
Women are more likely to suffer from this condition due to life events such as pregnancy, childbirth, and menopause, which can weaken or damage the pelvic floor muscles.
These muscles are crucial for supporting the bladder and keeping urine contained until ready to be released.
Unlike men, women have a shorter urethra, and any damage to it can more likely result in incontinence due to less muscle available to prevent leakage.
What are the symptoms of urinary incontinence?
Symptoms of urinary incontinence include a persistent urge to urinate, frequent trips to the bathroom beyond the normal eight times a day or more than twice at night, and, for some, bedwetting.
Treatment
There are several steps women can take at home to help treat urinary incontinence. Despite scepticism from some that these simple measures are effective, many women find that they can completely eliminate or significantly reduce urinary leakage by:
Performing Kegel exercises
These exercises can strengthen pelvic floor muscles if the problem is related to stress incontinence. However, if the pelvic floor muscles are too tight, Kegels may not be beneficial and could even worsen symptoms.
It's important to discuss symptoms with a healthcare provider before starting such exercises.
Bladder training
Scheduling bathroom visits can help manage an overactive bladder. This involves timing bathroom trips, and gradually increasing the interval between visits to train the bladder to hold urine longer.
Losing weight
Reducing body weight can alleviate pressure on the bladder and associated muscles, thereby improving bladder control.
Adjusting diet
Certain beverages like caffeine and alcohol may exacerbate bladder issues. Cutting back on these can make a difference.
Quitting smoking
Smoking can worsen urinary incontinence among other health issues.
Addressing constipation
Increasing dietary fibre can help with constipation, which can in turn alleviate bladder control problems.
In addition to lifestyle changes, protective pads and underwear designed to manage incontinence are available and can provide immediate relief while long-term solutions take effect.