Incontinence is never a popular topic for women. Many dread the possibility of incontinence, since it can significantly affect a woman’s quality of life. If they do experience signs of incontinence, many women find that asking for help can be embarrassing. Most women wait anywhere from two to nine years before they tell their doctor about these symptoms. However, many women may not be aware that effective treatment for incontinence is available.

We would like to focus on this topic in a two-part blog series. This week, we explain why incontinence occurs in women. Next week we will discuss various treatment options.

What is incontinence and pelvic floor dysfunction?

The International Incontinence Society defines urinary incontinence as “the compliant of any involuntary loss of urine. Urinary incontinence is a symptom or a sign, not a disease.” There are various types of incontinence: urge, stress, frequency, and mixed. Incontinence most often occurs when the muscles and nerves of the pelvic floor are compromised. The pelvic floor refers to the muscular base of the abdomen attached to the pelvis. While there are a number of causes for pelvic floor dysfunction, 85% of women in America experience this embarrassing and frustrating condition. Involuntary loss of urine can occur in women as young as 18 years of age (or less) and through the end of life.

What are the causes?

There are a number of causes for incontinence. Those that result from pelvic floor dysfunction typically occur due to:

  • Pregnancy and childbirth. The increased weight of the uterus on the bladder and then delivery can result in impairments to muscles, connective tissues and surrounding nerves. Over time, a weakened vaginal wall can result in a prolapse of bladder, uterus or rectum and potentially cause incontinence issues as well.
  • Aging. After menopause, women produce less estrogen, which may result in weakened muscles and thinned connective tissues of the pelvic floor. This decreases the ability to control bladder and bowel habits.
  • Surgery. Any surgery that involves the pelvic floor could eventually lead to pelvic floor dysfunction and incontinence. These may include hysterectomies, as well as episiotomies during childbirth. Urinary catheterization can also lead to incontinence due to urethral injury. 
  • Behavior. A few behavioral habits that may cause urinary incontinence include going to the bathroom “just in case” (before you leave the house, for example), voiding more than nine times per day, and rushing to the bathroom when an urge is felt. These behaviors train the bladder to “think” it can hold less urine than it is able and can result in urinary urgency/frequency.  
  • Diet. A diet high in acidic foods/fluids can cause urinary incontinence. Some examples of acidic drinks can include coffee, tea, sodas and fruit juices like cranberry juice. Also, inadequate consumption of water can cause irritation of the bladder from containing highly concentrated urine and resultant incontinence.
  • Medications. Some of the medications that can be a factor include these: diuretics, sedatives/muscle relaxers, and narcotics.  
  • Lack of exercise. An inactive lifestyle can lead to pelvic floor muscle weakness and innately cause urinary incontinence.
  • Sports. Those who are extremely active and/or participate in high-impact sports may exert excessive stress on their body and experience urinary incontinence.
  • Weight gain. Increased pressure on the bladder and the pelvic wall can result in incontinence over time.
  • Cognitive impairments.
  • Frequent urinary tract infections.

Stay tuned for next week's post where we discuss the various treatment options for incontinence and pelvic floor dysfunction. In the meantime, if you would like to schedule an appointment with a physician to discuss your incontinence symptoms, we recommend that you call our North Hills Hospital referral hotline at 1-855-5NHILLS.