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The Emotional Toll of Female Incontinence

Female incontinence is physical, but it can also have a psychological impact.
WebMD Feature
Reviewed by Louise Chang, MD

The family dinner was going well -- until a condition known as female incontinence got in the way. 

The middle-aged woman has urge incontinence, sometimes called overactive bladder (OAB). As the name suggests, when the urge to go to the bathroom comes on, it often can't be controlled. 

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Living With Overactive Bladder

You're sitting in a meeting when you have the sudden urge to pee. Immediately. Or you can't sleep because your bladder wakes you up. Maybe you've canceled plans because you don't always make it to the bathroom on time. And you're embarrassed to talk about it. No need to feel shame, says Maude Carmel, MD, assistant professor of urology at The University of Texas Southwestern Medical Center. "OAB [overactive bladder] is very common, and there are solutions." It affects nearly 4 in 10 women, according...

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She leaked urine through her clothes and onto her son and daughter-in-law's upholstered dining room chair, an embarrassment that didn't go unnoticed. 

After the cleanup, even with her daughter-in-law and other family members assuring her that everything was fine, the woman was so humiliated she now has trouble accepting invitations. 

Urinary incontinence is primarily a physical problem, affecting an estimated 12 million U.S. adults. But incontinence can also take an emotional toll on a person.

Emotional Toll of Female Incontinence

When you have female incontinence, you may avoid social situations and even sexual intimacy, and that in turn can lead to withdrawal and depression. 

"Incontinence is embarrassing," says Jennifer Anger, MD, MPH, an assistant professor of urology at the University of California Los Angeles David Geffen School of Medicine and an attending physician at Santa Monica -- UCLA Medical Center in Santa Monica, Calif. 

But if you get a medical evaluation when you first notice symptoms of female incontinence, your doctor can suggest a host of treatments that will improve or eliminate the condition. 

"Older women think it's a normal part of aging," Anger says, clarifying that it is not. While the condition does affect older women more than younger, it doesn't have to be a side effect of aging.

Female Incontinence and Depression

Depression is more common in women with female incontinence, according to several studies. In one study, published in a 2005 issue of Obstetrics & Gynecology, researchers found that nearly three times as many women with female incontinence had depression compared to those without the condition. 

They surveyed nearly 6,000 women, ages 30 to 90, with more than 40% of them reporting some degree of female incontinence. 

Another study, published in Social Science Medicine in 2005, found that urinary incontinence is associated with depression in both women and men. And if a woman is incontinent, her husband is also more likely to be depressed, the researchers found.

Female Incontinence Impact on Quality of Life

Not surprisingly, the more severe the urinary incontinence, the greater the impact on quality of life, report French researchers who evaluated 556 women with female incontinence and compared them to more than 2,000 women without the condition. These women had lower self-esteem, impaired well-being, and reduced sexuality compared to the women without female incontinence. 

Urinary incontinence in severe forms should be considered a disability, the French researchers conclude in their report, published in a 2006 issue of Neurourology and Urodynamics.

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