Health & Fitness
What Causes Incontinence & What To Do About It
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Health & Fitness
What Causes Incontinence & What To Do About It
Discover everything you need to know about bladder leakage.
If you’ve ever felt damp down there during a yoga class, not quite made it to the washroom on time, or sometimes pee when you laugh or cough, you're in good company. Roughly 1.5 million Canadians experience incontinence, including an estimated one in three women.
“It’s not something we should be hiding or ashamed of, because it happens more frequently than we want to imagine,” says Dr. Magali Robert, a professor in the Cumming School of Medicine and department of obstetrics and gynecology at the University of Calgary.
What causes bladder leakage?
According to Dr. Dante Pascali, a urogynecologist at The Ottawa Hospital and associate professor of obstetrics and gynecology at the University of Ottawa, incontinence can be caused by a variety of factors, at different points in a woman’s life. Pregnancy and childbirth, being overweight, frequent urinary tract infections and menopause can all be linked to pee leaks. “Women who start new medications like diuretics for high blood pressure may notice more urinary frequency and urgency,” says Dr. Pascali. And research has shown that women with chronic conditions, such as asthma and heart disease, are more than twice as likely to experience bladder leakage, too.
There are several types of bladder leakage issues. Overflow incontinence happens when you produce more urine than your bladder can hold, or your bladder doesn’t empty like it should and it gets too full, causing leaks. For women, some of the most common causes of overflow incontinence are medications, nerve damage, weak bladder muscles and blockages in the urinary tract.
Overactive bladder, which is also known as urge incontinence, happens when you have to use the washroom suddenly. Some women have little warning before they need to pee, while others spontaneously leak at the very suggestion of peeing (even the sound of running water can set some women off). This can lead to nighttime accidents or day- time mishaps when you’re not close enough to a washroom. “These women have a strong urge to pee, but leak urine en route to the bathroom,” says Dr. Pascali.
Stress incontinence is the most common type and accounts for about 50 percent of women who experience pee leaks. (Some of these women also have overactive bladder, a condition called “mixed incontinence.”) These leaks are caused by an inability to fully close the urethra, a tube that allows urine to leave the body. This is often due to weak or damaged pelvic floor muscles, which support the bladder like a sling. Extra pressure, caused by laughing, sneezing, coughing or exercise, can cause you to pass urine.
Little leaks can feel like a big deal
The fear of peeing your pants in a business meeting, or not being able to stay dry through a movie, Pilates class or dinner date, can become a major concern. If you don’t have complete confidence in your ability to hold it, you might start skipping your workouts, and even begin to avoid any potentially problematic social situations.
Some women also have real fears about leaking during intimacy, says Dr. Robert. “We talk about jumping on trampolines and make jokes about laughing so hard that you wet yourself, but we don’t talk about intimacy,” she says. There is little research into the prevalence of this part of the issue, but she suspects it’s much more common than we know. Bottom line: Pee leaks should not be getting in the way of your sex life or social life.
Managing bladder mishaps
Wearing an incontinence product, like a disposable pad or reusable absorbent underwear, can give you the confidence to move through your day, but they won’t solve the problem. “They can help patients cope with the leaking but are not a treatment,” says Dr. Pascali. Although surgical options are required, as a last resort, in some cases, there are a number of effective noninvasive remedies, too.
For women with stress incontinence, weight loss, dietary changes to deal with chronic constipation and smoking cessation are all possible management strategies. Pelvic floor muscle training can also play a key role. A pelvic floor physiothera- pist can assess the condition of your muscles and prescribe a range of therapies, from Kegel exercises to biofeedback training. “Stress urinary incontinence can also be treated conservatively with pessaries,” says Dr. Pascali. (These are rings fitted by a specialist that are inserted into the vagina to provide support.)
If you have an overactive bladder, there are bladder training exercises as well as prescription medications that can help. Avoiding common triggers, like caffeine and spicy or acidic foods (which are bladder irritants) and regulating your fluid intake, can also reduce bladder leakage. If you think a prescription drug you are taking, such as a pain medication, is an issue, talk to your doctor about adjusting your dosage or other alternatives.
What you shouldn’t avoid are aspects of your life that you relish, or otherwise benefit from, because you’re worried about incontinence. “We don’t want to discourage women from being active or doing activities they enjoy because they’re leaking,” says Dr. Robert.
Many women make the mistake of thinking they have to live with a leaky bladder, but for approxi- mately 90 percent of them, the problem can be managed one way or another. “If it’s affecting your quality of life, or your bladder is starting to dictate how you live your life, it’s time to talk to your doctor,” says Dr. Robert.
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