Causes of Urge Incontinence
Urge incontinence is just one of many different types of incontinence that women (and men!) can experience. To learn more about all the different kinds of urinary incontinence in women, check out this article that covers each type of urinary incontinence (including urge incontinence, stress urinary incontinence, mixed urinary incontinence, overflow incontinence and functional incontinence).
It’s easy to underestimate how prevalent the problem of urinary incontinence in women is. And it’s not just a problem belonging to women “of a certain age” either. Indeed, incontinence may affect people of any age and for many different reasons.
One of the reasons it’s so prevalent is that urinary incontinence is not itself a disease, but a symptom. And it’s a symptom of many different things. That’s also why there are different types of urinary incontinence.
But even within a single kind of urinary incontinence - like urge incontinence - there can be very different causes that vary in explanation, severity and treatment plan.
So before we dive into the causes, let’s level set on what exactly urge incontinence means…
How Does It Usually Work When You Pee?
Your brain and bladder work together to control urinary function.
The bladder stores urine until you are ready to release it and the muscles of your pelvis hold the bladder in place. The muscles of the bladder are usually relaxed and hold urine in the bladder and the neck of the bladder is closed.
The urethra is the tube that carries urine from the bladder to outside the body. The sphincter muscles are closed around the urethra. When those muscles do their job, urine does not leak outside the body by accident.
When you are ready to pee, your brain lets the bladder know. This causes the bladder muscles to contract which forces urine out through the urethra. The sphincter also opens up, allowing a flow of urine to pass through the urethra and leave the body.
Incontinence happens when urine leaks outside your control and intention to pee.
What Happens When You Have Urge Incontinence?
Urge incontinence is not considered a disease. But it can be a symptom of certain lifestyle choices or medical issues that may need to be addressed.
Urge incontinence manifests when there is a sudden and urgent need, or ‘urge’, to pee that seemingly comes out of nowhere.
If this urgent need cannot be immediately acted upon, this feeling can lead to involuntary urine leakage of small amounts of urine. Urge incontinence may be a temporary or persistent experience depending on the cause.
Because of its sudden and unpredictable nature, urge incontinence and the resulting loss of urine may be exceptionally difficult to live with, causing a lot of stress for those who experience this loss of control.
What Could Be Causing Urge Incontinence?
Urge incontinence has a few different possible causes, which all point to different conditions and treatment options. So it’s important to work with your healthcare provider to understand what might be the underlying issue.
Any of the following will be exacerbated by weak pelvic floor muscles or stress incontinence. Indeed the second most common form of incontinence is mixed incontinence, which is suffering from stress incontinence and urge incontinence simultaneously.
The causes of this type of incontinence include:
Bladder Infection or Stones
Temporary urge incontinence can be caused by a urinary tract infection (UTI), bladder infection, or bladder or kidney stones. In these cases, it will usually disappear once these conditions are treated, which will require a visit to your doctor.
Urinary tract infections or bladder infection are usually accompanied by other symptoms too. Those can include:
- Pain in the pelvic region
- Burning or pain with urination
If you experience any combination of these symptoms along with urinary incontinence, consider a visit to your doctor to investigate the cause and to discuss treatment options.
An Overactive Bladder (OAB)
An involuntary loss of urine can also be caused by an overactive bladder (OAB) - though it’s important to note that this does not always cause urinary incontinence and is not itself considered a disease.
According to the National Association for Incontinence about 17% of women and 16% men over 18 years old have OAB and an estimated 12.2 million adults have urge incontinence.
An overactive bladder can be caused when the muscles in your bladder are too active.
Diseases of the Nervous System
Urge urinary incontinence is sometimes not just a bladder problem, but it can point to a problem with how your brain and your bladder are communicating. There can be false messages that the bladder is full and needs emptying. Or “too late” messages that you need to urinate.
But because it also involves the brain, it can be linked to conditions like Parkinson’s Disease and Multiple Sclerosis.
According to the Mayo Clinic, “most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable.”
Other bladder cancer signs and symptoms may include:
- Blood in urine, which may cause urine to appear bright red or cola colored, though
- Frequent urination
- Painful urination
- Back pain
Should I See a Doctor?
We get it: Talking about your most intimate bodily functions isn’t always easy. But trust us, doctors are not fazed by these things.
If it helps you prepare for seeking medical advice, write down your questions and make some notes to anticipate the questions they may ask (we listed some questions in this article).
While experiencing incontinence can cause stress and embarrassment, talking about it with your healthcare professional should not!
How Will My Health Care Provider Treat Urge Incontinence?
Urge incontinence is not a disease. But it can be a symptom of something else going on. The treatment options will depend on the underlying reason why you leak urine.
You may be able to manage symptoms of an overactive bladder with simple behavioral strategies, such as:
Certain foods, including alcohol, caffeine and sugary or spicy foods can irritate the bladder causing an urgent need to urinate. Reducing consumption of these can help you regain bladder control.
Timed Voiding or Bladder Training
Bladder training can strengthen the pelvic floor muscles. One method involves peeing at certain scheduled times each day and ignoring the urge to urinate at other times. The time between when you empty your bladder can be increased as your muscles are strengthened and bladder control improves. Using this method, your ability to hold urine should improve with time.
Kegel Exercises (Pelvic Floor Muscle Exercises)
These exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. If you’re unsure how to do Kegel exercises or pelvic floor muscle exercises, your doctor or physiotherapist can help you. But basically it’s like pretending you have to urinate and then holding it; you relax and tighten the muscles that control urine flow.
If you're unsure what this feels like, next time you pee, try to stop the flow mid-stream and note the muscles you use. Your doctor may recommend performing Kegels daily to strengthen the muscles.
Some of the treatments you and your healthcare provider may discuss can include:
- Biofeedback therapy: This seeks to give you greater awareness of your body’s physiological responses.
- Botox injections: Small amounts of Botox injections (botulinum toxin) can stop the bladder muscle from contracting too much.
- Medications: Certain medications can be used to treat urinary incontinence and help you control urination. Medications can be used to calm an overactive bladder or to relax the bladder muscle and can increase the amount of urine your bladder may hold.
Many of these lifestyle changes and treatments recommended for urge incontinence - including Kegel exercises or pelvic floor exercises - will take time to have an effect. So, it’s also worth exploring ways to manage any leaks day-to-day.
Super absorbent leakproof underwear can hold up to 8 tsp of liquid (whether that’s sweat, blood or urine). Products like these can be a game changer for those experiencing urinary incontinence, allowing them to remain active and social while exploring treatment options.
If I Ignore Urge Incontinence, Will it Just Go Away?
There are temporary incidents of urinary incontinence. These are usually related to eating or drinking too much of certain beverages or foods. For example, too much coffee or alcohol, or even an excess of sugary or spicy foods.
Assuming you don’t continually consume foods and drinks in this manner, the incontinence may pass and you can just forget about it… apart from making a mental note for the future;)
However for the most part, if the underlying cause is not determined and addressed, it is unlikely that incontinence will just “go away”. It may not worsen either. If you have an overactive bladder, for example, it may not become more overactive. But it is also unlikely to resolve itself.
While the risks of ignoring incontinence are low, there is always a risk that you’re ignoring something more serious. Also, you’re ignoring the opportunity to explore treatments.
Ultimately, it’s a personal choice. However, if you experience incontinence and it’s accompanied by any other symptoms, particularly pain or bleeding, we definitely recommend seeing your healthcare provider. Odds are you’ll feel better just having them rule out the most worrisome possibilities!