Incontinence in Women: Causes, Treatments, and Management

Do you experience incomplete urination or urination too often? If yes, then you might have symptoms of incontinence. It is a common condition that occurs due to loss of bladder control, which makes it hard to manage urination. Although it is not life-threatening, it can affect your daily life. It can affect both men and women but is more common in women. Luckily, many treatment options are available to treat this condition. Learn what causes urinary incontinence in women and how it is treated in this article. Visit Doral Health and Wellness – Women’s Health Center and consult with the best Women’s health specialist in New York.

Causes of incontinence

Urinary incontinence can be caused by your daily habits, underlying medical conditions, physical problems, aging, and certain foods, drinks, or medication consumption. It can be short or long-term. Your doctor will perform a thorough evaluation to determine what’s causing your incontinence.

Common causes of short-term or temporary urinary incontinence in women are:

• Some foods: Foods high in spices, sugar, or acid, like citrus fruits, cause incontinence in women.
• Certain drinks: Drinks like alcohol, caffeine, carbonated drinks, or sparkling water can work as diuretics and temporarily increase the frequency or urine urgency.
• Medications or supplements: Some medications like heart and blood pressure medicines, sedatives, and muscle relaxants can cause incontinence in women. For some people, high doses of vitamin C also cause this condition.
• Constipation: When you have a hard, impacted stool in your rectum (the part that holds the stool before it gets released, located near the bladder and shares many of the same nerves), it puts stress on the nerves, which leads to increased urinary frequency.
• Urinary tract infection (UTI): Infections that irritate your bladder lead to strong urges to pee and, sometimes, incontinence.

Common causes of long-term or persistent urinary incontinence in women are:

• Pregnancy: During pregnancy, hormonal changes and the increased weight of the fetus put pressure on the bladder, which leads to stress incontinence.
• Childbirth: Having a vaginal delivery can weaken muscles that are needed for bladder control and support. It can also damage bladder nerves and supporting tissues, causing a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum, or small intestine can be pushed down from the actual position and protrude into the vagina. These protrusions may lead to incontinence.
• Age-related changes: Aging of the bladder muscle can lower the bladder’s capacity to store urine. Additionally, involuntary bladder contractions may become more common as you get older.
• Menopause: After menopause, women produce less estrogen in the body, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of the lining can aggravate incontinence.
• Obstruction: If you develop a tumor anywhere along the urinary tract, it can block the normal flow of the urine, leading to overflow incontinence. Urinary stones can sometimes cause urine leakage.
• Neurological disorders: Conditions like multiple sclerosis, Parkinson’s disease, stroke, brain tumor, or spinal injury that interfere with nerve signals of bladder control can cause urinary incontinence.

Symptoms

Urinary incontinence symptoms can vary between people depending on the type of incontinence they have. They include:

• Stress incontinence: This occurs when pressure is applied to the bladder due to coughing, sneezing, laughing, exercising, or lifting heavy, which leads to urine leakage.
• Urge incontinence: This occurs suddenly and causes an intense urge to pee, followed by an involuntary loss of urine. You may need to pee often, even at night. This may be caused by a minor condition like infection or severe conditions like neurological disorder or diabetes.
• Overflow incontinence: This may cause you to feel frequent or constant dribbling of urine due to the bladder not getting empty completely.
• Functional incontinence: A physical or mental impairment can prevent you from getting to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough to pee.
• Mixed incontinence: You may experience more than one type of urinary incontinence – most people experience a combination of stress incontinence and urge incontinence.

Treatment

Urinary incontinence treatment depends on several factors, including the type of incontinence, its severity, and the underlying cause. Sometimes, a combination of treatments may be needed. If you have an underlying condition that causes your symptoms, your doctor may treat the condition first.

Usually, the doctor uses less invasive treatments to treat your symptoms or moves to other options if those techniques don’t help.

1. Behavioral changes: Your doctor may recommend some behavioral techniques to train your bladder. It may include:
2. Bladder training: This helps you delay urination after you have the urge to go. To do this, try to hold your urge to urinate for 10 minutes and increase the period over time. The goal is to lengthen the time between trips to the toilet until you’re urinating only every 2.5 to 3.5 hours.
3. Double voiding: This helps you learn how to empty your bladder to avoid overflow incontinence. It means urinating, then waiting for a few minutes and trying again.
4. Schedule toilet trips: This helps you to urinate every 2 to 4 hours rather than waiting for the need to go.
5. Fluid and diet management: This helps you regain control of your bladder. You may need to cut some foods or drinks like alcohol, caffeine, or acidic foods to ease your problem. Sometimes, lowering the liquid intake, losing weight, or increasing physical activity is also recommended.

• Pelvic floor exercises: Your doctor may recommend some pelvic floor exercises to strengthen the muscles that help control urination. These exercises, also known as kegel exercises, are very effective in managing stress incontinence and even helpful for urge incontinence. To perform pelvic floor muscle exercises, you can:
• Tighten (contract) the muscles that allow you to stop urinating and hold it for 5 seconds, and then relax for 5 seconds. If it is too difficult, try to start by holding it for two seconds and relax for 3 seconds.
• Work up to hold the contractions for 10 seconds at a time.
• Aim for at least three sets of this exercise, 10 repetitions each day.

To find the right muscles to contract, your doctor may suggest working with a pelvic floor physical therapist or trying biofeedback techniques.

• Medications: Some medications commonly used to treat incontinence include:
• Anticholinergics: These medications produce a calming effect on the overactive bladder, which may be helpful for urge incontinence. It includes oxybutynin, tolterodine, darifenacin, fesoterodine, solifenacin, and trospium chloride.
• Mirabegron: It is used to treat urge incontinence by relaxing the bladder muscle and increasing the amount of urine that your bladder can hold. It may also increase the amount of urination, helping to empty your bladder.
• Topical estrogen: These are low-dose estrogen available in the form of vaginal cream, ring, or patch that may help tone and rejuvenate tissues in the urethra and vaginal areas.

• Electrical stimulation: In this therapy, doctors attach electrodes inside your rectum or vagina to stimulate and strengthen pelvic floor muscles by sending gentle electrical stimulation. It is effective for stress and urge incontinence, but you may need multiple treatments over several months.
• Medical devices: These devices are designed to treat women’s incontinence, including:
• Urethral insert: It is a small, tampon-like disposable device inserted into the urethra before a specific activity like tennis to prevent triggering incontinence. It acts as a plug to prevent leakage.
• Pessary: It is a flexible silicone ring that you insert into your vagina and wear all day. It is also helpful for women with vaginal prolapse. It supports the urethra to prevent urine leakage.

• Surgery: If other treatments fail to produce desired results, surgery is recommended to treat the cause of urinary incontinence.
• Sling procedures: It uses synthetic material or strips of your body’s tissue to create a pelvic sling underneath your urethra and the area of thickened muscle where the bladder connects with the urethra. This sling is used to keep the urethra closed, especially when you sneeze or cough. It is used for treating stress incontinence.
• Bladder neck suspension: This procedure is used to provide support to the urethra and bladder neck – an area of thickened muscle that connects the bladder to the urethra. It involves an abdominal incision, which is done under general or spinal anesthesia.
• Prolapse surgery: This surgery is recommended for women who have pelvic organ prolapse with mixed incontinence. This surgery involves a combination of a sling procedure and prolapse surgery because repairing the pelvic organ prolapse alone won’t improve urinary incontinence symptoms.
• Artificial urinary sphincter: In this procedure, a small, fluid-filled ring is implanted around the urinary bladder’s neck to keep the urinary sphincter shut until you need to urinate. To urinate, you press a valve implanted under your skin that causes the ring to deflate and allows you to urinate from your bladder.

Tips for Prevention of Incontinence

While you can’t always prevent urinary incontinence, some tips can help you lower the risk. It includes:

• Learn and practice pelvic floor exercises.
• Maintain a healthy weight.
• Limit or avoid the intake of caffeine, alcohol, and acidic foods.
• Eat more fiber; that’ll help you prevent constipation, a common cause of urinary incontinence.
• Empty your bladder regularly before physical activity.
• Quit smoking, if you do.

Incontinence in women is more common than you think. Many factors can cause incontinence in women, and the symptoms can affect your daily life activities severely. Luckily, many treatment options for incontinence in women are available depending on the type, severity, and underlying cause of the condition. Talk with your doctor to get the right treatment for your condition and manage your symptoms.

If you need help with incontinence, visit our women’s health specialist in Brooklyn Clinic to get professional medical help. Call us to book your appointment now!!!! Log on to  www.doralhw.org or visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212 to book an appointment.  At Doral Health and Wellness – Women’s Health Center, we have the best GYN doctor in Brooklyn, and we provide women with quality health care services. You can also visit our website at https://doralhw.org/department/gynecology/