Talking About Urinary Incontinence

Many women have been there or know women who have: You’re laughing to the point of tears, or you’re jumping up and down during a workout, when suddenly…oops.

Leaking urine, especially as we age, is something many women have experienced from time to time. But when do these accidents mean something more? National Women's Health Week (#NWHW #FindYourHealth) is the perfect time to examine this issue, one that affects millions of women every day.

Urinary incontinence, or UI, is the technical name for the involuntary loss of urine. Women may say they have “a weak bladder” or “bladder leakage.” While these aren’t medical terms, they refer to the same condition. Urinary incontinence can be mild—just a few drops, or severe—a large volume of urine leakage or the complete loss of a full bladder.

UI affects women of all ages and may be related to hormonal changes, such as menopause, or to childbirth or injury to the pelvic floor, the group of muscles and connective tissues nested inside the pelvis. If left untreated, UI can progress and worsen over time, even if it seems to wax and wane over shorter periods of time. The severity and the number of women who report incontinence increases with age—from 37% of women in their 30s up to 64% of women in their 80s reporting symptoms.

While UI is common—affecting over 20 million women in the U.S. and 250 million women worldwide—it does not need to be normal, and it can have significant negative impacts on women’s lives. The uncertainty and unpredictability that come with UI can affect women’s mental health, quality of life and relationships. Women may limit their physical activity or social engagements, experience feelings of isolation and distress and/or experience problems with intimacy. The financial burden is significant as well. Women with UI report spending $500+ each year on pads and protective garments, laundry and dry cleaning. The global $12 billion adult diaper market is a grim reality.

Despite these real, life-altering implications of UI, too many millions of women “just live with it.” Some are embarrassed or reluctant to discuss their symptoms with their doctors. Others know that pelvic floor muscle exercises, commonly referred to as Kegels, can help train muscles to reduce involuntary bladder leaks. Despite this, there is significant under-utilization of these exercise programs and many women find them difficult to perform on their own.

Pelvic floor muscle training (PFMT) involves a program of exercises that is typically supervised and followed regularly for a period of several weeks or months. This is much different than “doing your Kegels here and there”, at a stoplight, or every few weeks when you happen to remember them. Women who complete PFMT are significantly more likely to report cure or improvement of symptoms when compared to those who do not.

There are several options for completing an effective PFMT program. Seeing a specialized pelvic health provider – such as a physical therapist, occupational therapist, or other advanced practice provider - can be a great option for exercise instruction, supervision, and program design!

A few places to look for a skilled pelvic health provider near you are the following websites: PT Locator from APTA Academy of Abdominal and Pelvic Health, Herman and Wallace Pelvic Rehabilitation Institute Provider Directory, and the Pelvic Guru Provider Directory.

Alternatively, your healthcare provider may provide you with information about a home pelvic floor exercise program. There are also smartphone applications and devices available to help you with daily practice! Not all devices are created equal, however. Aim for an FDA-cleared device supported by published data and clinical studies that allows your healthcare provider to participate in your journey. I’m clearly partial to our device at Renovia, as it checks those boxes noted previously, has several features designed to support successful PFMT, and is unique in using real-time visualization of movement during muscle contraction and relaxation as the primary way of delivering feedback.  

In addition to training pelvic floor muscles, it is helpful to avoid or quit smoking, to maintain a healthy weight and to exercise regularly. Managing your diet and fluid intake is also important. Certain foods and caffeine, alcohol and carbonated drinks may irritate your bladder and worsen symptoms.

If you or someone you know has UI and wants to do something about it, this is a great time to act! Effective treatments are available to help you take charge of your UI. This quiz can help you rate your bladder health and provide a better picture of how UI may be affecting your life. Remember: bladder health is just another component of your overall health. So, talk to your healthcare provider about your specific symptoms and learn about treatment options that are available to you.

If you’re one of the millions of women affected by UI, it’s important to realize that moderate to severe symptoms of urine leakage do not need to be accepted as normal. The good news is that if it bothers you and limits how you live your life, you can do something about it! Treatment is within reach – including many drug-free and non-surgical options – making it easier than ever to take control of your pelvic floor health. Go #FindYourHealth!

#NWHM #FindYourHealth #WomensHealth