It may be normal to have a rare sprint-to-the-bathroom emergency. Maybe after a long car ride or when you can't stop laughing at a funny story. But if you often leak or have an accident, it’s time to talk to your doctor. Incontinence can be embarrassing, but it's treatable.
Female urinary incontinence, or the loss of bladder control, is grouped into two main types. Stress incontinence causes urine to leak when you laugh, cough, exercise, or lift something heavy. Urge incontinence occurs without warning. It’s also called overactive bladder, an umbrella term that includes people who need to urinate frequently and suddenly. It's possible to have a mix of both types of incontinence.
Many women think incontinence is a normal part of aging, or that it's taboo to discuss, even with a doctor. But it isn’t -- and it doesn't have to control your life.
Physical Condition, Emotional Toll
Incontinence can cause anxiety, says Karen Noblett, MD, director of urogynecology at the University of California Irvine. Fear of an accident can cause women to alter their daily routines.
"Some people have mild symptoms and are able to plan their lifestyles around it," Noblett says. "But for some, it's devastating -- they become socially isolated and won't leave their home or go anywhere they're unfamiliar with the bathroom situation."
Urge incontinence is a challenge to manage because the need to go comes out of the blue. "Women will say, 'I don't think I can sit through a movie, so I'll stay home," Noblett says. "Or 'I can't sit on an airplane tarmac for an hour, so I won't travel anywhere I have to fly.'"
Stress incontinence is easier to predict, but some women avoid physical activity because they know it's a trigger, says Mamta Mamik, MD, assistant professor of obstetrics and gynecology at the Ichan School of Medicine at Mount Sinai Hospital in New York City. They may also shy away from sex, which can affect their relationship with their partner.
Studies show that women with incontinence are up to three times more likely to be depressed, and so are their partners. Scientists believe there may be a link between urge incontinence and mood disorders, since both are affected by chemicals in the brain.
Why Your Doctor Should Know
If incontinence affects your lifestyle or mood, it's time to talk to your doctor. Many women don't consider this an option, or they're nervous about treatment. One study found that less than half of women with the condition sought treatment.
But there are good reasons to bring it up: About 80% of the women in the study who did get treatment reported an improvement. And actually, Noblett says, many solutions don't involve surgery.
Your doctor may suggest you keep a record of your diet, behaviors, and bathroom activities, called a voiding diary. "We'll look at how many times you urinate or leak throughout the day and under what circumstances, and from there we can usually advise women to change certain habits," Mamik says.
Other treatments include medications, behavioral therapy, biofeedback (learning to control your bodily functions), and several types of implants and shots. In 2013, for example, Botox (injected into the bladder muscles) was approved to treat overactive bladder.