Recent research suggests over 60% of women in the United States deal with urinary incontinence, a 10% increase over prior estimates.1 But despite of the fact that this percentage relates to nearly 80 million women, a large University of Michigan survey found two out of three hadn’t mentioned their incontinence issues to a healthcare provider.2
Understanding urinary incontinence, including the main types and why it happens, may give you a better idea of how to cope with this common concern. We teamed up with Attn:Grace, a leader in incontinence care, to dig into the topic further.
What is Urinary Incontinence?
Urinary incontinence is the medical term for involuntary leakage of urine from the bladder.3 There are two main types of urinary incontinence that most often affect women.
- Stress incontinence is the most common type of incontinence in women, says Dr. Barbara Frank, OBGYN and Medical Advisor at Attn:Grace. “It happens when everyday movements – like sneezing, laughing, or lifting something heavy – put pressure on the bladder, leading to leaks,” Dr. Frank says. “It’s especially common after childbirth or as we age.”
- Urge incontinence is a need to urinate so sudden and urgent that you may not make it to the bathroom before leakage occurs.4
Some women may experience symptoms of both stress and urge incontinence. This is known as mixed incontinence.5
What Causes Urinary Incontinence?
Urinary incontinence has a variety of causes. These are some of the most common ones for women.
Pregnancy and Childbirth
Hormonal and anatomical changes during pregnancy and after giving birth (particularly vaginally) may weaken the muscles of the pelvic floor, which work together to support the bladder and other organs in your pelvis.6
This means that women who are postpartum may have a harder time controlling their bladders, and experience leakage as a result. It’s been found that approximately 30% of women deal with urinary incontinence after giving birth.7
Menstruation
The hormonal fluctuations that accompany a woman’s menstrual cycle may also contribute to incontinence. Rising progesterone levels during the second half of your cycle is linked to increased bladder contractions, while the dip in estrogen that occurs after ovulation may weaken pelvic floor muscles — both of which can have an impact on urinary incontinence.8,9
Perimenopause
Another time when hormone changes may cause incontinence? Perimenopause.
As women move closer to menopause, estrogen levels become extremely volatile and then drop. Since estrogen helps keep the muscles that support the bladder strong, lower estrogen levels can lead to less bladder control.10
A recent study done in perimenopausal women published in the International Journal of Health Sciences and Research found roughly 47% of participants experienced urinary incontinence.11
Menopause
Once a woman has gone 12 consecutive months without a menstrual period, she is officially menopausal. Low estrogen coupled with age-related physiological changes may further weaken the pelvic floor and worsen bladder control during this transitional time.12
Incontinence is actually the most common symptom of the lower urinary tract after menopause, affecting an estimated 38% to 55% of postmenopausal women over 60.13
“Most of the connection between perimenopause and menopause and incontinence is due to the ‘simple” things’: As you age, gravity takes over and your pelvic floor muscles start to relax and there’s an increased risk of incontinence,” Dr. Frank says. “Maybe you’ve had children, and your pelvic floor is weaker due to either a vaginal or cesarean birth. The drop in estrogen that accompanies perimenopause, and menopause also is tied to pelvic floor weakness.”
Higher Body Weight
Women with heavier bodies may be more vulnerable to urinary incontinence because weight, particularly in the midsection – which is common during menopause, puts pressure on the bladder and pelvic floor muscles. This pressure can lead to both stress and urge incontinence.14
Surgery
Some people may experience involuntary bladder leakage after a surgical procedure. This is called postoperative urinary incontinence (POUI), and it can be caused by factors such as nerve damage, strained pelvic floor muscles and even certain medications.15
Managing Incontinence
You may not always be able to control the many factors that contribute to incontinence, but there are steps you can take to manage symptoms and keep yourself more comfortable.
“The first step? Understand what’s really going on,” Dr. Frank advises. “To figure out which you’re dealing with, start with tracking your patterns. A simple voiding diary – noting what you drink, when you go, and how often – can offer real insight into what your bladder needs.”
Other ways to manage incontinence include:
Kegel Exercises
Doing Kegel exercises helps to strengthen the muscles of your pelvic floor, giving you better bladder control. To do a Kegel, tighten the muscles in your pelvic floor you’d use to stop urination for five seconds, then relax for five seconds and repeat. When done regularly, Kegels may reduce urinary incontinence by 70%.16
Schedule Your Bathroom Breaks
Urinating according to a schedule can help to retrain the way your brain and bladder communicate, giving you more control. Bladder training can “stretch your bladder’s capacity over time,” Dr. Frank says. Taking a bathroom break every 3-6 hours may help to minimize leaks.17
Lifestyle Tweaks
If you’re finding that incontinence is interrupting your routine activities, there are things you can do. Dr. Frank suggests making “lifestyle tweaks to limit bladder irritants such as coffee and alcohol.” Research indicates cutting caffeine can reduce incidence of both stress and urge incontinence.18
Supplies on Hand
Having a stash of pads and a change of clothes in your glove compartment or desk drawer can be a lifesaver when you’re caught off guard by bladder leaks.
Be sure to always look for quality incontinence support products; those that are clean, transparently produced with plant-based ingredients and durable. We like those made by Attn: Grace.
Offering varying levels of support ranging from liners to briefs, Attn: Grace products are made with materials that are absorbent and moisture-wicking but also free of fragrances, dyes and other irritating chemicals. Comfortable and discreet yet highly effective, they are designed to be tough on leaks but gentle on skin.
When to See a Healthcare Provider
If urinary incontinence is diminishing your quality of life, or if you’re concerned it may be a symptom of something else, be sure to speak with your healthcare provider. “Seek support from your doctor – whether it’s pelvic floor therapy, medications or more advanced treatments,” Dr. Frank says. “There’s no one-size-fits-all solution, but the good news is: There’s a lot you can do, and you don’t have to figure it out alone.”
Resources:
- https://pubmed.ncbi.nlm.nih.gov/35030139/#
- https://www.michiganmedicine.org/health-lab/nearly-half-women-over-50-experience-incontinence-most-havent-talked-doctor
- https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808
- https://my.clevelandclinic.org/health/diseases/22161-urge-incontinence
- https://my.clevelandclinic.org/health/diseases/22161-urge-incontinence
- https://pubmed.ncbi.nlm.nih.gov/30649605/
- https://www.ajog.org/article/S0002-9378(24)00419-8/fulltext
- https://pubmed.ncbi.nlm.nih.gov/11762662/
- https://www.medicalnewstoday.com/articles/frequent-urination-before-period#causes
- https://menopause.org/patient-education/menopause-topics/symptoms
- https://www.ijhsr.org/IJHSR_Vol.14_Issue.11_Nov2024/IJHSR04.pdf
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6528037/
- https://www.sciencedirect.com/science/article/pii/S0378512220303674
- https://www.nature.com/articles/s43856-023-00367-w
- https://www.auajournals.org/doi/10.1016/j.juro.2017.04.097
- https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768776
- https://www.health.harvard.edu/blog/new-recommend-kegels-and-other-treatments-for-incontinence-women-201409177438
- https://www.sciencedirect.com/science/article/abs/pii/S1071575401643882
