According to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Woman’s Hospital at Michigan Medicine,some form of urinary incontinence – sometimes referred to as bladder leakage – affects approximately half of all women over the age of 20. This is especially true for older women.
But what causes bladder leakage, and why is it so much more common in women than in men? The following article will define the most common types of urinary incontinence in women and discuss the unique health events, such as pregnancy and menopause, that affect women’s pelvic and bladder health.
Types of urinary incontinence in women
Urinary incontinence is defined as the loss of bladder control. In a healthy bladder, the brain and bladder communicate to release urine when the bladder becomes full, and muscles around the bladder and urethra help control the process. Bladder muscles tighten to push out the urine, while sphincter muscles relax to allow the urine to be released through the urethra.
In the absence of normal communication between the brain and bladder, or if the pelvic muscles have been weakened due to age, disease, or a medical event, it can become difficult or impossible to hold in urine, causing bladder leakage.
Below are the main types of bladder leakage affecting women.
Urge incontinence
Urge incontinence is a type of urinary incontinence in which a person experiences a sudden, intense urge to urinate, followed by the involuntary loss or leakage of urine. Many people refer to overactive bladder, or OAB, as urge incontinence. However, urge incontinence is just one of several potential symptoms of OAB. Others include frequent urination (urinating more than 8 times in a period of 24 hours) and nocturia (excessive nighttime urination).
If you’re experiencing urge incontinence, especially alongside frequent urination and/or nocturia, you may have OAB and should discuss your symptoms with your healthcare provider.
Stress incontinence
Stress incontinence is bladder leakage caused by pressure on the bladder. This can be caused by anything from coughing, laughing, sneezing, exercising, or even standing up. Other potential causes of stress incontinence in women especially include pregnancy (the fetus can put pressure on the bladder), childbirth (which can affect the functioning of bladder and pelvic muscles), menopause, and female anatomy (e.g., the female urethra is shorter than the male urethra).
Mixed incontinence
In mixed incontinence, a person experiences both urge incontinence (OAB) and stress incontinence. Mixed incontinence is common for women who have bladder leakage and should not be interpreted as a natural symptom of aging, as many people assume. Mixed incontinence can indicate underlying health conditions including not just OAB, but also infections (such as UTIs), diabetes, or in some instances neurological diseases (such as Parkinson’s or Multiple Sclerosis).
Your doctor can evaluate which particular category you may fall into, as different types of leakage may require different treatments. Keep reading to learn more about what causes bladder leakage in women.
What causes bladder leakage in women?
As mentioned above, urinary incontinence is a major symptom of OAB and can be managed and treated if properly diagnosed. As such, it’s important that your doctor understands your particular symptoms and medical history in order to determine if your bladder leaks are caused by any of the following:
- Pregnancy: Pregnant women are at higher risk for bladder leakages, particularly stress incontinence, due to increased fetal weight and/or hormonal changes.
- Childbirth: Vaginal births can weaken the pelvic muscles and damage bladder nerves and supportive tissue. In some cases, people can experience what is known as a prolapsed pelvic floor, in which part of the bladder can get pushed down from its usual position into the vagina, which can be associated with incontinence.
- Aging and menopause: The aging process can cause the muscles around the bladder and urethra to weaken. Aging can also decrease the bladder’s capacity, which can cause more frequent bladder leakages. In women specifically, menopause reduces the amount of estrogen the body produces, which can in turn lead to deterioration of the lining of the bladder and urethra and possibly incontinence.
Other risk factors for urinary continence include being overweight, smoking, and a family history of urinary incontinence. In addition, the consumption of fluids that act as diuretics – such as coffee, tea, and alcohol – can increase the frequency of bladder leakages.
Managing and treating OAB-related bladder leakage in women
Urinary incontinence has significant effects on quality of life. Many women feel their lives are “run” by their frequent bladder leakages, and are forced to sacrifice travel, certain types of recreation or exercise, and other everyday activities. Bladder leakages can be a cause for embarrassment, and it can be understandably uncomfortable to discuss symptoms with your doctor.
However, because incontinence is not necessarily a normal part of aging and can indicate an underlying condition such as OAB, it’s important to talk to your doctor. With a proper diagnosis, your doctor can help you pursue one of the following management and treatment options:
Behavioral methods
One way to start managing your symptoms is to keep a bladder diary. This helps you keep detailed track of your leakages – for example, when leakages occur and if they’re triggered by pressure (stress incontinence) or not – as well as any other symptoms that may be related, such as nocturia or frequent urination.
Once you understand your symptoms, a doctor may recommend behavioral treatments such as bladder training, pelvic floor or Kegel exercises, dietary changes, and/or fluid management.
Medications
Several medications can be prescribed to treat OAB symptoms, such as urge incontinence. As with any medication, you’ll need to weigh the pros and cons of medications against potential side effects. Finding the right medication can also take some trial and error.
Advanced therapies
When behavioral interventions and medication do not help bladder leakages fully resolve, advanced therapies may be recommended. For some, surgical procedures for prolapse, bladder neck suspension, and even artificial sphincters may be necessary. For others, electrical stimulation delivered through nodes or through an implant can stimulate the nerves involved in bladder control, reducing urinary incontinence.
Learn more about Axonics Therapy
Knowing what causes bladder leakage is an important first step in your road to better bladder functioning. Axonics has developed an advanced Sacral Neuromodulation Therapy to treat OAB symptoms like urinary incontinence through gentle stimulation to the nerves that communicate between the brain and bladder. This advanced therapy restores normal communication which can result in symptom improvement. Read more about Axonics Therapy today to see if this treatment option is right for you.
Disclaimer: Axonics does not provide medical advice, diagnosis or treatment. The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
