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    The Emotional Toll of Female Incontinence

    Female incontinence is physical, but it can also have a psychological impact.

    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.

    Female Urge Incontinence

    While all types of female incontinence can cause emotional distress, urge incontinence is far more distressing, says Halina Zyczynski, MD, associate professor of obstetrics and gynecology at the University of Pittsburgh School of Medicine and a specialist in female incontinence at the Magee-Womens Hospital.

    It's the unpredictable nature of urge incontinence that makes it so distressing, she says. Urge incontinence isn't totally understood, but experts think the bladder muscle may give the wrong messages to the brain, with the bladder feeling fuller than it really is. As a result, a person with urge incontinence feels the urgent need to go to the bathroom, even if they have just done so.

    Stress incontinence, which causes urine to leak when lifting objects, laughing, coughing, or sneezing because of weakened pelvic floor muscles, is less emotionally draining, Zyczynski says. "Women can learn which positions or situations predispose them to stress incontinence [and avoid them]."

    "If you know, for instance, that doing the Stairmaster makes you leak [urine], you can avoid it," she says. "If you know that sneezing [makes you leak urine], as your sneeze comes on, you can cross your legs or squeeze your pelvic floor muscles."

    But, unlike stress incontinence, urge incontinence occurs without warning and is especially upsetting. "Before a woman has a chance to respond to that urge to go [to the bathroom], urine is already running down her leg," says Zyczynski.

    The sheer volume of leaking urine associate with urge incontinence is another reason why this condition is so distressing. Women with stress incontinence tend to leak urine in small amounts, perhaps a teaspoon or a tablespoon, says Zyczynski. But with urge incontinence, a woman can leak a cup or two of urine, saturating an absorbent pad and soaking through their clothing.

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