Medically Reviewed by W. Brad Campbell, MD

As a women experiencing bladder leakage, the first thing you should know is: You are not alone.

“Urine or bladder leakage is a problem experienced by about half of adult women,” says McLeod Gynecologist, Dr. Brad Campbell. “Fifty percent of women will experience stress incontinence during their life time. One in three women over the age of 60 will experience some type of pelvic health problem. It’s unfortunate that embarrassment about this most personal of problems will keep many women from talking about the problem and enjoying an active lifestyle.”

Stress Incontinence is the most common cause of incontinence in younger women, often as young as 20 and the second most common (next to “urge” incontinence or overactive bladder) in older women. Stress incontinence occurs when the muscles of the pelvic floor and vagina weaken. It’s a bit like using fingers to keep air escaping from a balloon. If the seal isn’t tight and strong, there will be leakage.

For some women this may simply be an issue of aging. As we grow older, many of our muscles weaken or atrophy. The pelvic area is no different. Pregnancy and childbirth can also weaken and stretch pelvic muscles, leading to stress incontinence.

Ironically, young, athletic women may also experience stress incontinence. Their exercise may cause the bladder to move downward, pushing slightly at the bottom of the pelvis, where the muscles cannot control the flow of urine. This is called “prolapse.”

The week before their menstrual period – when muscles are receiving lower estrogen levels – women see an increased chance for leakage, as well.

Physical movements — a sudden laugh cough, sneeze or even vigorous romance — can trigger some incontinence. The action puts “stress” on the bladder and urine can escape.

The Bladder Diary. Before you see you doctor, keep a diary of when and how often these leakage episodes occur. What activities seem to trigger it? How much urine are you leaking? This will help your doctor determine which treatment might be right for you.

Treating Stress Incontinence.

• Weight loss can improve stress incontinence. Extra weight puts additional pressure on the bladder, making the possibility of stress leakage more likely.
• Although it’s not really treating the underlying problem, a woman can wear an absorbent pad or panty liner.
• Like all muscles, the pelvic area muscles can benefit from exercise. “Kegels” were developed in 1948 by Arnold Kegel. The exercise consists of repeatedly contracting and relaxing the muscles of the pelvic floor. Stronger muscles can lead to a tighter bladder seal.
• In some cases, medication can increase the tone of the muscles of the bladder area, preventing leakage from stress incontinence.
• Surgery, using slings or suspension techniques, move the bladder back into place and tightens the muscles.

Consulting your personal physician is the best way to determine the most effective treatment for stress incontinence. Your doctor may want to look inside perform simple testing in the office to determine the extent of your bladder issues. These tests can be performed during your visit so treatment options can be discussed immediately. Seeing a gynecologist that specializes in treatment of stress incontinence is the first step in improving women’s quality of life.

In upcoming articles we’ll discuss “urge incontinence” another problem women frequently experience.

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Sources: McLeod Health, National Women’s Health Resource Center, Center for Pelvic Health, American Urogynecologic Society Women to Women, National Institutes of Health, American Academy of Family Physicians.