Urinary Incontinence in Women

This article was medically reviewed by Dr. Navya Mysore and updated on June 18, 2024

Urinary Incontinence in Women

Of the 25 million adult Americans suffering from some form of urinary incontinence, 75-80% are women (source). 

You might expect that if a condition like incontinence, which can have a tremendous impact on lifestyle and emotional stress, is so widespread among women, it would be widely understood. That couldn’t be less the case. 

Many women wait over 6 years from when they first experience symptoms to when they receive a diagnosis. Like other female symptoms, like period pain, women’s issues can often be dismissed by doctors as just “the hand we’re dealt.”

It’s no wonder, then, that half of us don’t even bother seeing the doctor for these symptoms!

But incontinence deserves to be better understood. Indeed, “urinary incontinence” as a blanket term to explain any and all forms of involuntary bladder leakage is a bit misleading. That’s because there are different kinds of incontinence, and while they all result in urinary leakage, the “why” can be very different. Let’s explore!

Urinary Incontinence: An Overview

Urinary incontinence is any experience of involuntary peeing or urine leakage. Urinary incontinence could be sudden and infrequent or persistent and recurring. Or it could be persistent and recurring—even, in some cases, something people live with daily.

It impacts both men and women, though it is more common in women - occurring almost twice as often. Pregnancy, childbirth, and menopause are major reasons for the increased prevalence of incontinence in women as compared to men. 

Urinary incontinence in women can also be accompanied by other symptoms, like a sudden urge to urinate, bladder contractions, or a feeling of pressure on your bladder.

But What Normally Happens 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.

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 when the bladder contracts, allowing the urine to pass through the urethra and leave the body.

Incontinence happens when urine leaks outside your control and your intention to pee.

Incontinence may occur for many reasons, and, indeed, there are different “types” of incontinence with different causes and treatment options. While your doctor is the best person to provide you with a full and proper diagnosis and treatment plan, there are some steps you can take independently to manage incontinence and prevent it.

You can help manage urinary incontinence day-to-day with lifestyle products like leakproof incontinence underwear. These can help you fully participate in your life without fear of a leak at an inopportune moment.

5 Different Types of Female Urinary Incontinence

There are 5 different types of female urinary incontinence. Each one has subtle differences. Plus, it’s possible to experience more than one kind.

1. Urge Incontinence

We all experience the urge to pee - it can even feel urgent when we’ve had excess fluid intake (alcohol or carbonated drinks in particular) or have held the urge to urinate for a long time. 

Urge incontinence is when an urgent urge to urinate comes seemingly out of nowhere. It can happen even if they’ve urinated recently. And if they can’t get to the bathroom in time, a urinary accident may happen. 

Urge incontinence may be caused by a miscommunication between your brain and your bladder. There can be false messages that the bladder is full and needs emptying. 

Because it also involves the brain, urge incontinence can sometimes be linked to neurological conditions like Parkinson’s Disease and multiple sclerosis (MS). But urge incontinence can also be caused by pregnancy (which puts pressure on the bladder), childbirth, menopause, overactive bladder, or trauma from surgery.

Treatment options for urge incontinence can include biofeedback therapy, which seeks to give you greater awareness of your body’s physiological responses and help control the bladder muscle. Exercises to strengthen the pelvic floor muscles (i.e., Kegels) can help, too; while they won’t eliminate the urge, they can help ensure it doesn’t lead to a leak.

2. Stress Incontinence

Stress urinary incontinence (SUI) has nothing to do with emotional stress but is about physical exertion. This can be because of exercise but also due to involuntary reactions like coughing, sneezing, laughing, and having sex.

When any of those exertions cause an involuntary loss of bladder control resulting in leakage of urine, it’s called stress incontinence. Stress incontinence is usually caused by weaker pelvic floor muscles and muscles that become weaker when the body is experiencing the ‘stress’ of those exertions, you can experience loss of bladder control.

Your pelvic floor muscles are, after all, just like any other muscle: They can be injured, damaged, or weak because of age and not getting enough exercise. Damage to the pelvic muscles of the bladder and urethra can happen to women due to childbirth or trauma from surgery (e.g., hysterectomy). And weakened muscles can happen because of aging (menopause) and lack of exercise. This is one of the reasons why Kegel exercises (pelvic floor muscle training) are so often recommended to reduce stress incontinence.

3. Mixed Incontinence

Mixed incontinence is when a person experiences both urge and stress incontinence. It’s not uncommon to experience both issues with bladder control. Mixed incontinence is, in fact, the second most common form of incontinence in women. 

If you have mixed incontinence, you likely have weakened pelvic muscles in combination with other possible health concerns that cause you to leak urine. Working with your doctor will help pinpoint what's causing your bladder control problems.

Treatments for mixed bladder control issues include lifestyle changes, medication, and bladder botox injections.

4. Overflow Incontinence

If you pee frequently, but it has an unsteady, dribble-like flow of urine, this could point to overflow incontinence. With this type of incontinence, the bladder cannot fully empty when you pee, and the amount of urine you eliminate may be small. Because your kidneys continually produce urine, this can lead your bladder to overflow later, without warning.

In addition to the stress this kind of sudden incontinence can cause, it also puts you at risk for urinary tract infections (UTI). This is because urine should be regularly expelled from the body, but if the bladder isn’t emptying, the urine that remains can become a breeding ground for bacteria.

In women, overflow incontinence can be caused by weak bladder muscles, an underactive bladder, or a blockage in the urinary tract. An underactive bladder can be caused by certain medications, diabetes, alcoholism, and other medical conditions. Blockages in the urinary tract are sometimes caused by other surgeries or unusual growths.

Treatment for overflow incontinence varies from case to case but may include surgery to remove urinary tract blockages, review of medications and lifestyle adjustments, or the use of a catheter.

5. Functional Incontinence

Functional incontinence is probably the easiest form of incontinence to understand because it isn’t caused by any damage to the urinary system but usually by another medical condition.

This kind of incontinence can have neurological or psychological causes. It might be a mental health issue that causes a person to ignore their urge to pee or a disease like dementia that can impact a person’s self-awareness or judgment. 

But it can also be caused by physical impairments, which prevent a person from acting on their need to urinate. These can include physical obstacles, such as spinal cord injuries and mobility issues.

Functional incontinence most often affects the elderly, and treatment often includes nursing assistance that includes bathroom reminders. Changing physical settings to ensure unimpeded access to bathrooms may also help. Other treatments can involve medications and therapies to improve the person’s physical and mental well-being.

Risk Factors: What Increases Your Likelihood of Experiencing Urinary Incontinence?

The risk of incontinence is greater in women. Damage to the pelvic floor muscles or the muscles of the bladder and urethra can happen to women due to childbirth or trauma from surgery (e.g., hysterectomy). And weakened pelvic muscles can happen because of aging (menopause) and lack of exercise. 

• Additional factors that increase the risk of incontinence include:
• Age
• Being overweight
• Smoking
• Family history
• Other diseases (e.g., diabetes, MS, Parkinson’s Disease)
• Having been through pregnancy and childbirth
• Having undergone certain pelvic surgeries (e.g., hysterectomy)
• Dementia 

Lifestyle Changes You Can Make to Help

Whether incontinence is temporary or persistent, there are lifestyle changes you can make to manage your symptoms while living with incontinence.

Reduce Risk Factors

Quitting smoking, reducing alcohol consumption, and maintaining a healthy weight can help reduce the risk of urinary incontinence issues.

Do Pelvic Floor Muscles

These exercises strengthen the pelvic muscles, which support the uterus, bladder, small intestine, and rectum. There’s no reason to wait to start doing pelvic muscle exercises, and they can help at any stage.

Try Products Like Leakproof Underwear

Experiencing incontinence can cause a great deal of stress. It even prevents some people from participating in events and outings, leading to isolation, and possible depression. While you explore treatment options with your doctor, you can also explore products to help you stay active and social. Leakproof underwear comes with different absorbency levels.

Time Your Bathroom Breaks

Taking bathroom breaks on a schedule may help you manage urge and overflow urinary incontinence. Over time, you can increase the time between bathroom breaks. This kind of bladder training can help with urinary frequency.

Seeking Medical Advice: What to Expect & How to Prepare

If you experience incontinence, you should book an appointment to see your doctor. You may be shocked to learn that 50% of people ignore their incontinence symptoms.

These are some of the questions your doctor may ask you about your urinary incontinence symptoms.

• How long have you been experiencing these symptoms?
• Have your symptoms been continuous or occasional? Have they worsened over time?
• How often do you need to urinate?
• When (time of day or night) do you experience urine leakage?
• Is it difficult for you to empty your bladder?
• Have you noticed any blood in your urine?
• General lifestyle questions: Smoking, diet, alcohol, caffeine consumption, etc.

Here are some questions you might ask your doctor:

• What type of incontinence do I have?
• What is causing my urinary incontinence
• What tests should I expect?
• Should I make lifestyle changes?
• What treatment(s) do you suggest and why?
• Without treatment, what will happen?
• What are the side effects or risks associated with this treatment plan?

Treatment of Urinary Incontinence

The lifestyle changes we outlined earlier in the article are probably where your doctor will start too:

• Pelvic floor exercises and pelvic floor therapy
• Bladder training
• Dietary or fluid intake changes to minimize or eliminate diuretics like caffeine and alcohol

Depending on your individual experience and medical history, your doctor might also want to explore:

• Medication that can treat an overactive bladder or relax the bladder
• Medical devices, like urethral inserts or pessaries
• Interventional therapies, such as Botox or nerve stimulation
• Surgery, which can include bladder sling or pelvic organ prolapse surgery

No matter what kind of urinary incontinence you experience, or what treatment plan you decide to follow, it’s unlikely to clear up overnight. 

Because of this, you’ll want to make lifestyle changes so you can cope in the short term. 

Many people who experience incontinence find they’re worried about the embarrassment of an accident. To help manage this, super absorbent Knix leakproof underwear is a solid choice. Products like these can be a game-changer for those experiencing incontinence, allowing them to remain active and social while exploring treatment options. 

Sources: 

https://phoenixpt.com/statistics/#:~:text=Stress%20urinary%20incontinence%2C%20the%20most,adult%20women%20in%20the%20U.S.&text=About%2017%25%20of%20women%20and,million%20adults%20have%20urge%20incontinence.

https://knix.com/blogs/resources/what-is-urge-incontinence

https://knix.com/blogs/resources/stress-incontinence-everything-you-need-to-know

https://knix.com/blogs/resources/what-is-overflow-incontinence

https://knix.com/blogs/resources/how-to-deal-with-incontinence

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We hope you found this post informative—but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.